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Adapting a small change behavioral weight management program for college students: formative evaluation and iterative
Jacqueline F Hayes1,2, Jessica Gokee LaRose3, Annabelle Derrick2
1Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States.
Translational Behavioral Medicine
|July 18, 2026
Summary
College students can achieve weight loss through a tailored behavioral intervention delivered via health centers. The HealthyU program, adapted using student feedback, improved retention and effectiveness, demonstrating a viable approach for emerging adults.
Area of Science:
- Public Health
- Behavioral Science
- Health Psychology
Background:
- College health centers can deliver behavioral weight management interventions to emerging adults.
- Emerging adults are a hard-to-reach population for improving cardiometabolic health.
Purpose of the Study:
- To adapt an evidence-based weight gain prevention program for weight loss in college students.
- To improve intervention fit for delivery in college health centers using the Adaptome framework.
Main Methods:
- Iterative adaptation based on student and staff interviews and focus groups.
- Pilot testing in single-arm trials with benchmarks for retention, adherence, and effectiveness.
- Refinement of delivery, coaching, self-monitoring, and content based on feedback and results.
Main Results:
- Initial adaptations addressed environmental and developmental barriers identified through interviews.
- Four cohorts were piloted, with significant refinements made after each.
- The final HealthyU intervention exceeded benchmarks for retention (≥70%), adherence (≥75%), and weight loss (≥3%).
Conclusions:
- College students benefit from group interaction, community, text message support, and autonomy-supportive coaching.
- The HealthyU intervention shows promise for weight management in emerging adults.
- Future research should test HealthyU against a control in a generalizable sample.
