Gender Differences in Indoor Tanning Habits and Location

To the Editor, In 2013, 1.9 million US men reported tanning indoors. Existing research largely target teen and young adult female tanners, and less is known about male tanning behavior. Using Survey Sampling International, we recruited a nationally representative sample of 773 adults who intend to use or used an indoor tanning bed. Participants reporting a lifetime history of tanning indoors (n=636; 33.5% male) were included...

Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study

BACKGROUND: Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. OBJECTIVE: This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. METHODS: Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. RESULTS: Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). CONCLUSIONS: Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. TRIAL REGISTRATION: ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2). Danielle E Jake-Schoffman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 20.06.2018

The Association Between Psychiatric Disorders and Frequent Indoor Tanning

Limited research has explored psychiatric disorders associated with indoor tanning and tanning dependence. In a study conducted in 2006 of students at a large university in the northeastern United States, 90 of 229 (39%) who had used indoor tanning facilities met criteria for tanning dependence,a tanning pattern highly resistant to intervention. Given that tanners report mood and physical appearance as reasons for tanning, psychological disorders, such as seasonal affective disorder (SAD) and body dysmorphic disorder (BDD), may be common among this population. Past research found that 12 of 27 (44%) frequent indoor tanners met criteria for SAD compared with 14 of 56 (25%) nontanners. Other studies have found that stress in general is predictive of tanning dependence,and tanners have been shown to report lower levels of stress after tanning. Ashrafioun and Bonarreported that 57 of 165 (35%) tanners who met criteria for tanning dependence also met criteria for BDD, compared with 77 of 368 (21%) tanners who did not meet these criteria. In the study described here, we assessed the prevalence of SAD, clinically elevated stress, and BDD among a sample of women who frequently use indoor tanning, and we examined bivariate associations between tanning dependence and these psychological conditions

A Non-Restrictive Weight Loss Diet Focused on Increasing Fiber and Lean Protein: Results of a Pilot Trial

Objective. The vast majority of diets are not only multicomponent but also restrictive. Dietary fiber or protein can reduce hunger and enhance satiety; they also exert clinical benefits. We examined feasibility and acceptability of a non-restrictive diet combining the two for weight loss. Population and Methods. Fifteen patients were enrolled in the trial (2 men, 13 women, mean age=48 y and mean BMI = 36 kg/m2) to attend 6 bi-weekly individual counselling sessions for the diet during the 12-week study period. The goals of the intervention were to attain a daily goal of higher fiber (\u3e35g)/ and lean protein (120g). 24-hour diet recalls and body weight were collected at baseline, 6- and 12-week assessments. Results. All participants completed 6-week assessment, one participant dropped from the study before 12-week assessment. At 12 weeks, 93% of participants liked the diet much/very much, 92% were very/extremely confident in adhering to the diet and 85% did not feel hungry on the diet. Mean fiber intake increased by 9.4 g/day (95% CI: 5.9, 12.8) at 6 weeks, and by 6.9 g/day (CI: 3.3, 10.5) at 12 weeks. Protein intake increased by a mean of 13.7 g/day (CI: 4.8, 22.6) at 6 weeks, and by 6.0 g/day (CI: -3.3, 15.3) at 12 weeks. % of calories from saturated fat decreased by 2.0% (CI: 0.5, 3.4) at 6 weeks and by 2.7% (CI: 0.5, 3.4) at 12 weeks. Alternative Healthy Eating Index score increased by 9.7 (CI: 5.3, 14.0) at 6 weeks and by 6.1 (CI: 1.5, 10.7) at 12 weeks. Mean weight loss was -2.7 lbs (CI: -4.9, 0.6) at 6 weeks and -4.7 lbs (CI: -8.0, -1.4) at 12 weeks. Conclusion. Participants liked the diet prescribed, and significantly increased their fiber and lean protein intake, resulting in significant weight loss with improvement to dietary quality

Adapting Behavioral Interventions for Social Media Delivery

Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals--a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality

Engaging Moms on Teen Indoor Tanning Through Social Media: Protocol of a Randomized Controlled Trial

BACKGROUND: Indoor tanning elevates the risk for melanoma, which is now the most common cancer in US women aged 25-29. Public policies restricting access to indoor tanning by minors to reduce melanoma morbidity and mortality in teens are emerging. In the United States, the most common policy restricting indoor tanning in minors involves parents providing either written or in person consent for the minor to purchase a tanning visit. The effectiveness of this policy relies on parents being properly educated about the harms of indoor tanning to their children. OBJECTIVE: This randomized controlled trial will test the efficacy of a Facebook-delivered health communication intervention targeting mothers of teenage girls. The intervention will use health communication and behavioral modification strategies to reduce mothers\u27 permissiveness regarding their teenage daughters\u27 use of indoor tanning relative to an attention-control condition with the ultimate goal of reducing indoor tanning in both daughters and mothers. METHODS: The study is a 12-month randomized controlled trial comparing 2 conditions: an attention control Facebook private group where content will be relevant to teen health with 25% focused on prescription drug abuse, a topic unrelated to tanning; and the intervention condition will enter participants into a Facebook private group where 25% of the teen health content will be focused on indoor tanning. A cohort of 2000 mother-teen daughter dyads will be recruited to participate in this study. Only mothers will participate in the Facebook groups. Both mothers and daughters will complete measures at baseline, end of intervention (1-year) and 6 months post-intervention. Primary outcomes include mothers\u27 permissiveness regarding their teenage daughters\u27 use of indoor tanning, teenage daughters\u27 perception of their mothers\u27 permissiveness, and indoor tanning by both mothers and daughters. RESULTS: The first dyad was enrolled on March 31, 2016, and we anticipate completing this study by October 2019. CONCLUSIONS: This trial will deliver social media content grounded in theory and will test it in a randomized design with state-of-the-art measures. This will contribute much needed insights on how to employ social media for health behavior change and disease prevention both for indoor tanning and other health risk behaviors and inform future social media efforts by public health and health care organizations. CLINICALTRIAL: Clinicaltrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807 (Archived by WebCite at http://www.webcitation.org/6mDMICcCE)

Clinic Versus Online Social Network-Delivered Lifestyle Interventions: Protocol for the Get Social Noninferiority Randomized Controlled Trial

BACKGROUND: Online social networks may be a promising modality to deliver lifestyle interventions by reducing cost and burden. Although online social networks have been integrated as one component of multimodality lifestyle interventions, no randomized trials to date have compared a lifestyle intervention delivered entirely via online social network with a traditional clinic-delivered intervention. OBJECTIVE: This paper describes the design and methods of a noninferiority randomized controlled trial, testing (1) whether a lifestyle intervention delivered entirely through an online social network would produce weight loss that would not be appreciably worse than that induced by a traditional clinic-based lifestyle intervention among overweight and obese adults and (2) whether the former would do so at a lower cost. METHODS: Adults with body mass index (BMI) between 27 and 45 kg/m(2) (N=328) will be recruited from the communities in central Massachusetts. These overweight or obese adults will be randomized to two conditions: a lifestyle intervention delivered entirely via the online social network Twitter (Get Social condition) and an in-person group-based lifestyle intervention (Traditional condition) among overweight and obese adults. Measures will be obtained at baseline, 6 months, and 12 months after randomization. The primary noninferiority outcome is percentage weight loss at 12 months. Secondary noninferiority outcomes include dietary intake and moderate intensity physical activity at 12 months. Our secondary aim is to compare the conditions on cost. Exploratory outcomes include treatment retention, acceptability, and burden. Finally, we will explore predictors of weight loss in the online social network condition. RESULTS: The final wave of data collection is expected to conclude in June 2019. Data analysis will take place in the months following and is expected to be complete in September 2019. CONCLUSIONS: Findings will extend the literature by revealing whether delivering a lifestyle intervention via an online social network is an effective alternative to the traditional modality of clinic visits, given the former might be more scalable and feasible to implement in settings that cannot support clinic-based models. TRIAL REGISTRATION: ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618

A Community-Based Social Networking Intervention to Increase Walking in Dog Owners

Roughly 40% of U.S. households own a dog and while dog ownership is associated with greater engagement in physical activity, up to 60% of dog owners do not achieve the recommended 150 minutes of weekly physical activity. The present study aims to develop and test a dog walking intervention addressing individual, interpersonal, and community factors. The study represents collaboration between UMass Medical School, UMass Lowell and their community partners, Common Pathways and the Greater Lowell Health Alliance. The developmental phase uses a community-based participatory research approach by creating community advisory boards and conducting focus groups with residents to ensure community perspectives are represented throughout intervention development. Information gathered from the developmental phase will inform the intervention. The intervention phase will determine the feasibility and efficacy of a multi-component dog walking intervention using a group randomized controlled trial. The intervention uses a social networking website, newsletters, pedometers, neighborhood walks, and community events to educate owners on the benefits of walking, create a supportive environment, and increase the “dog friendliness” of a community. Communities in Worcester and Lowell will be randomized to the intervention or control condition. Outcome measures include pedometer steps, time spent walking the dog, social support for exercise, and sense of community. This study is one of the first studies to test whether increasing dog walking in dog owners can increase owner physical activity via a social networking website. If successful, we will assess the extent to which the community can sustain the intervention

Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population

BACKGROUND: The prevalence of metabolic syndrome (MetS) increased recently and there was still not a screening index to predict MetS. The aim of this study was to estimate whether brachial-ankle pulse wave velocity (baPWV), a novel marker for systemic arterial stiffness, could predict MetS in Chinese community population. METHODS: A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012. MetS was diagnosed according to the criteria of the International Diabetes Federation (IDF). Multiple Logistic regressions were conducted to explore the risk factors of MetS. Receiver operating characteristic (ROC) curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS. RESULTS: The mean age was (45.35+/-8.27) years old. In multiple Logistic regression analysis, the gender, baPWV and smoking status were risk factors to MetS after adjusting age, gender, baPWV, walk time and sleeping time. The prevalence of MetS was 17.48% in 30-year age population in Shanghai. There were significant differences (chi(2) = 96.46, P \u3c 0.05) between male and female participants on MetS prevalence. According to the ROC analyses, the ideal cutoff point of baPWV was 1 358.50 cm/s (AUC = 60.20%) to predict MetS among male group and 1 350.00 cm/s (AUC = 70.90%) among female group. CONCLUSION: BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group

Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series

BACKGROUND: Lifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden. OBJECTIVE: Online social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss. METHODS: We conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention. RESULTS: In Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media. CONCLUSIONS: Future research should evaluate the efficacy and cost-effectiveness of online social network-delivered lifestyle interventions relative to traditional modalities