Date of Award

8-2022

Degree Name

MS in Agriculture - Food Science and Nutrition

Department/Program

Food Science and Nutrition

College

College of Agriculture, Food, and Environmental Sciences

Advisor

Angelos Sikalidis

Advisor Department

Food Science and Nutrition

Advisor College

College of Agriculture, Food, and Environmental Sciences

Abstract

This study aimed to determine the feasibility of three distinct self-monitoring modalities employed as part of a weight-loss intervention among Spanish- and Mixtec-speaking women with low-no literacy who were overweight or obese (body mass index, BMI> 25). Primary outcomes assessed include self-monitoring adherence, weight, body composition, and diet quality. Participants (n=18) were recruited from the Cal Poly Women and Infants Mobile Health Unit, and contacted if they had a BMI> 25 and did not attend school beyond elementary level (6th grade). Upon enrollment, participants were asked to attend a weekly meeting at which the lifestyle intervention was delivered by a trained research assistant. In addition, all participants were randomized to one of three self-monitoring modalities (written-diary, photographs, audio-recordings), which they were prescribed to adhere to throughout the study. Adherence was evaluated weekly and participants were provided tailored feedback the day following the group meetings. Body composition and dietary habits were assessed at pre- and post-intervention visits. Participants (N=18; aged 41.3 ± 7.3 years; 100% female; BMI 34.6 ± 4.0) in all three groups were assessed on four different measures of adherence to self-monitoring (% total adherence, ≥3 submissions, ≥2 submissions, ≥1 submission). Percent total adherence ± standard deviation (SD) was on average 44.1 ± 34.4% with 48.8% in the written-diary group, 46.4% in the photos group and 37.1% in the audio-recording group (p=0.878). In accordance with previous studies supporting the efficacy of self-monitoring in weight loss, adherence was also assessed on 75% of days weekly. Upon examining ≥2 and ≥3 submissions daily for 75% of days weekly, adherence was highest in the written-diary group (54.4% and 49.1%, respectively), followed by the photos (15.1% and 38%, respectively) and audio-recording groups (20.7% vs 30.6%). Body composition and weight were assessed using an electronic scale and Tanita Bioelectrical Impedance Scale (BIA) scale at baseline and post-intervention. Weight loss observed was 6.4 ± 3.5 lbs (mean ± SD or 3.7% body weight (BW). Weight loss was greatest in the photos group with 7.6 ± 4.7 lbs, followed by the audio-recording group with 6.8 ± 3.9 lbs, and the written-diary group with 4.8 ± 4.2 lbs (p=0.588). Change in percent body fat was not significantly different across the three groups with an average of 2.1 ± 1.6% body fat lost. Mean attendance at weekly intervention meetings was 76.4% and was similar across groups. Finally, diet quality was significantly improved during the intervention with a reported 20.8% increase in consumption of servings of fruit daily, a 54.5% increase in servings of vegetables consumed daily, and overall 82.4% more participants using measuring cups while preparing food, and 58% less participants consuming fast food in the past 7 days.

The application of written-diaries, photographs and audio recordings are all feasible and acceptable modalities of self-monitoring for promoting self-regulation in a population of Hispanic women with BMI>25 and low-literacy. Future research efforts should continue to explore the application of existing and novel self-monitoring methods in order to determine the most optimal way to engage with this subpopulation.

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