SOCIAL MEDIA MESSAGE T YPE, ENGAGEMENT, AND WEIGHT CHANGE IN A 6-MONTH BEHAVIORAL WEIGHT LOSS INTERVENTION Sarah Hales, LMSW Charis Davidson, MPH Brie Turner-McGrievy, PhD Arnold School of Public Health Health Promotion, Education, and Behavior OBJECTIVE To examine Whether different types of social network messages differentially affect participant engagement If engagement with social media enhances weight loss as part of a 6-month behavioral weight loss intervention THE NEW DIETS TRIAL • The New Dietary Interventions to Enhance the Treatments for weight loss (New DIETs) study: • 2-month weight loss intervention, with • An optional 4-month follow-up period. INTERVENTION: MONTHS 0-2 All groups: • Orientation and overview of diets in group meeting • Diet information handouts • Recipe books Vegan, vegetarian, pesco-veg, and semiveg: • Weekly group meetings (8 total) Omnivorous group: • Monthly meetings (3 total) • Weekly newsletters • Weekly e-mails INTERVENTION: MONTHS 3-6 • All groups, including the omnivorous group, met monthly face-to-face. • All groups were provided with a private Facebook group for social support in between meetings. METHODS Data are a sub-analysis from a 2-month randomized weight loss study with 4-month follow-up support provided via private Facebook groups and monthly meetings. Counselors posted 5 different message types/week based on Social Cognitive Theory (similar to format of group classes). Order of messages each week was random except for weight messages (posted each Monday). FACEBOOK MESSAGE T YPES TARGETING SCT CONSTRUCTS Message Types Weight Loss Recipe Targeted Social Cognitive Theory Construct Self-control Behavioral capability Observational Learning (when links to videos of cooking demos were provided) Nutrition Study, Science, or Situation News Poll Targeted various constructs but was included to mirror the questions counselors would ask of participants during face-to-face meetings Suggestion/Request Expectations Emotional coping response FACEBOOK MESSAGE EXAMPLES Message Types Weight Loss Message Examples “How has your weight loss been since last week? Up, down, or about the same?” Recipe “This makes for a great snack, sandwich spread, or pasta topping: (Link to recipe) Nutrition Study, “Here is a great list of plant-based sources of calcium. Ever Science, or added kale to a smoothie? (link to website)” News Poll “What’s the most challenging meal for you to prepare each day? Breakfast, Lunch, Dinner, or Snacks.” Suggestion/ “Share with the group and help others. How have you dealt Request with a weight plateau (or gain) recently?” MEASURING ENGAGEMENT Responses to counselor-posted messages: Views Likes Comments and poll votes Engagement was dichotomized using a median split (of total likes, comments, and poll votes over course of the study) OTHER MEASURES Baseline, 2 months, 6 months: Height (SECA 213, using a calibrated stadiometer) Weight (SECA 869, Hamburg, Germany, calibrated digital scale accurate to 0.01 kg) Facebook message preference Assessed in the survey administered at 6 months DEMOGRAPHICS Joined, not Joined, engaged Did not join Total engaged P-value for difference between groups n 15 15 33 63 Meetings 1.7±1.4 3.7±0.8b 1.8±1.4 2.3±1.5 attended in 4-month follow-up P<0.001 Participants were mostly highly educated (94% college or higher), white (79%), females (73%), with a mean age of 48.5 ± 8.3 years. WHICH MESSAGE TYPE PROMPTED THE MOST USER ENGAGEMENT? MEAN NUMBER OF COMMENTS AND POLL VOTES PER POST IN RESPONSE TO DIFFERENT T YPES OF COUNSELOR FACEBOOK MESSAGES 20 Mean number of poll votes and comments per message type 18 16 Sig greater than all, P<0.05 14 Sig greater than nutr news & recipes, P<0.05 12 10 Sig greater than nutr news & recipes, P<0.05 8 6 F=60.3, P<0.001 4 2 0 Poll Request Weight Nutr News/Info Recipe MEAN NUMBER OF LIKES TO DIFFERENT T YPES OF COUNSELOR FACEBOOK MESSAGES Mean number of likes per message type 8 Sig greater weight, recipe, & nutr news, Sig greater than weight & recipe, P<0.05 7 Sig greater than weight, P<0.05 6 5 4 3 F=20.6, P<0.001 2 1 0 Request Poll Nutr News/Info Recipe Weight EXPOSURE TO DIFFERENT T YPES OF COUNSELOR FACEBOOK MESSAGES Mean number of views per user by message type 25 20 15 10 P=0.67 5 0 Request Poll Nutr News/Info Recipe Weight RESULTS OF MESSAGE T YPE AND ENGAGEMENT Exposure was similar for all message types. Posts asking participants to vote in a poll or request suggestions for the group are the most engaging as measured by both comments/poll votes and likes. WHICH MESSAGES DID PARTICIPANTS REPORT LIKING THE MOST AT THE END OF THE STUDY? Message preference as reported by participant Recipes Nutrition news and info Polls Requests for suggestions 5% 14% 52% 29% No one reported liking the weight posts. WAS ENGAGEMENT WITH FACEBOOK ASSOCIATED WITH WEIGHT LOSS? Facebook engagement was significantly associated with weight loss during the 4-month maintenance period (B= -0.09, P=0.04) such that for every 10 posts, comments, poll votes, or likes to Facebook, participants lost a mean of 0.43 kg. FACEBOOK ENGAGEMENT AND WEIGHT LOSS Facebook engagement was significantly associated with weight loss during the 4-month maintenance period (B= -0.09, P=0.04) such that for every 10 posts, comments, poll votes, or likes to Facebook, participants lost a mean of 0.43 kg. -0.4kg 10 posts! WEIGHT LOSS BY 3 ENGAGEMENT LEVELS AT 2 MONTHS 0 Baseline 2-months -2 Pounds lost -4 Joined, not engaged Joined, engaged Didn't join -6 -8 -10 P=0.90 -12 -14 Adjusted for meeting attendance WEIGHT LOSS BY 3 ENGAGEMENT LEVELS AT 6 MONTHS 0 Baseline 2-months -2 Sig diff from Didn’t join and Joined, engaged P<0.01 -4 Pounds lost 6-months Joined, not engaged Joined, engaged Didn't join -6 -8 -10 -12 -14 P=0.90 P=0.008 Adjusted for meeting attendance CONCLUSIONS Messages soliciting feedback, such as polling features, prompt the most engagement when counselors post messages in a social network during a weight loss trial. Engagement with social media was associated with greater weight loss during the maintenance period. The findings provide evidence for ways to provide social support during weight loss interventions using remote methodology.