After testing a new video-based intervention aimed at promoting a healthier lifestyle among low-income moms, the researchers point to two factors for its success rate: The study was designed to appeal to the participants’ personal values and instill in these mothers enough confidence to take on the challenge of pursuing a healthier life.
The participants were women who face stubborn health challenges — highly stressed overweight low-income mothers of young children. These women are at risk for lifelong obesity and potential problems for themselves and new babies if they become pregnant again.
“I asked them during focus groups who should be in the videos, and they said, ‘We want to see us. And our children. Do not lie to us and hire professionals, because we’ll be able to tell,’” said Dr. Mei-Wei Chang, lead author of the study and associate professor of nursing at The Ohio State University.
“They said, ‘We want to see them before the change and the struggles they had, and what happened after that.’”
As a group, the participants who watched the videos and talked to their peers over 16 weeks were more likely to have reduced their fat consumption than women in a comparison group who were given print materials about lifestyle change.
“My experience with this population is that they really want to make a change. Some might perceive that they don’t want to. But they do — they just don’t know how to,” Chang said.
The researchers focused on two psychosocial factors: autonomous motivation (what’s important in a person’s life) and self-efficacy (a person’s confidence in her ability to carry out a behavior or task). Previous research has shown that poverty can lead to low self-efficacy.
Autonomous motivation differs by population. In focus groups before the intervention began, women told the researchers that they wanted to be role models for their children. They hoped to be less stressed and happier, and to maintain good family relationships.
The study recruited participants (ages 18 to 39) from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which serves low-income pregnant, postpartum and breastfeeding women and children up to age 5. Those eligible for the program must have an annual household income no higher than 185 percent of the federal poverty line.
The moms’ body mass index ranged from 25.0 to 39.9, from the lowest indicator of being overweight to just below the extreme obesity range. The intervention was aimed at preventing weight gain by promoting stress management, healthy eating and physical activity. This study analyzed only the diet-related results.
During the trial, the 212 participants randomized into the intervention group watched a total of 10 videos in which women like them gave testimonials about healthy eating and food preparation, managing their stress and being physically active.
In the videos, the women wore casual clothes and told their stories, unscripted. They demonstrated meal prep with familiar foods and showed that simple, practical steps — like reading food labels — could gradually lead to a healthier lifestyle.
“They talked about a lot of things I didn’t know,” said Chang, who has worked with women enrolled in WIC for about 20 years. “They spoke their mind about what was important — like how they mentally dealt with changing behavior but not losing weight. And about being afraid to fail.”
The participants also dialed in to 10 peer support group teleconferences over the course of the study.
In phone interviews, the researchers asked the mothers about what they were eating, their confidence in sticking to a low-fat diet and why they wanted to eat more healthfully.
Overall, compared to the group reading print materials, the moms who watched videos and spoke with their peers reported larger increases in autonomous motivation and self-efficacy and a more significant decrease in fat intake after the 16-week intervention.
“Essentially, they said, ‘If she could do it, I could do it.’ That’s why we used peers to develop the intervention,” Chang said.
The study is published online in the journal Appetite.
Source: Ohio State University
Source: PsychCentral Inspiring Stories From Other Women Help Overweight Moms Improve Diet