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Does Effectiveness of Weight Management Programs Depend on the Food Environment?
Elizabeth Tarlov1,2, Coady Wing3, Howard S Gordon4,5
1Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL.
Health Services Research
|September 25, 2018
Summary
The Veterans Affairs MOVE! weight management program effectively reduced body mass index in men and women. However, its effectiveness was slightly diminished for men residing near fast-food outlets or convenience stores.
Area of Science:
- Public Health
- Health Services Research
- Behavioral Medicine
Background:
- Population-scale behavioral weight management programs are crucial for public health.
- Understanding how the food environment influences program effectiveness is essential for optimizing interventions.
- Geographic access to food retailers can impact health behaviors and outcomes.
Purpose of the Study:
- To estimate the causal impact of the Veterans Affairs (VA) MOVE! weight management program on body mass index (BMI).
- To investigate whether the program's effectiveness is moderated by participants' proximity to food retailers, including supermarkets, fast-food restaurants, and convenience stores.
Main Methods:
- Utilized secondary data from VA clinical records, commercial retail food environment databases, and the American Community Survey (2008-2014).
- Employed difference-in-difference regressions with propensity score matching to assess the program's effect on BMI at 6 months.
- Analyzed treatment effects overall and within subgroups defined by access to various food retail outlets.
Main Results:
- The MOVE! program demonstrated a significant reduction in BMI, approximately 0.71 units for men and 0.70 units for women.
- A modest decrease in effectiveness was observed for men living in areas with greater access to fast-food restaurants or convenience stores.
- No significant variation in treatment effects was found concerning the food environment for women.
Conclusions:
- The residential food environment has a moderate influence on the effectiveness of the MOVE! program, particularly for men.
- Further research is needed to fully understand environmental barriers and facilitators for intentional weight loss.
- This study underscores the critical interplay between healthcare delivery and community-level factors in promoting weight management.
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