Arnold School of Public HealthHealth Promotion, Education, and Behavior

SOCIAL MEDIA MESSAGE TYPE, ENGAGEMENT, AND WEIGHT

CHANGE IN A 6-MONTH BEHAVIORAL WEIGHT LOSS

INTERVENTION

Sarah Hales, LMSWCharis Davidson, MPHBrie Turner-McGrievy, PhD

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

OBJECTIVE

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

Vegan, vegetarian, pesco-veg, and semi-veg:

• Weekly group meetings (8 total)

Omnivorous group:

• Monthly meetings (3 total)

• Weekly newsletters

• Weekly e-mails

All groups:• Orientation and overview of diets in

group meeting• Diet information handouts• Recipe books

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.

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).

METHODS

Message Types Targeted Social Cognitive Theory Construct

Weight Loss Self-control

Recipe Behavioral capabilityObservational Learning (when links to videos of cooking demos were provided)

Nutrition Study, Science, or News

Situation

Poll Targeted various constructs but was included to mirror the questions counselors would ask of participants during face-to-face meetings

Suggestion/Request ExpectationsEmotional coping response

FACEBOOK MESSAGE TYPES TARGETING SCT CONSTRUCTS

Message Types

Message Examples

Weight Loss “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, Science, or News

“Here is a great list of plant-based sources of calcium. Ever added kale to a smoothie? (link to website)”

Poll “What’s the most challenging meal for you to prepare each day? Breakfast, Lunch, Dinner, or Snacks.”

Suggestion/Request

“Share with the group and help others. How have you dealt with a weight plateau (or gain) recently?”

FACEBOOK MESSAGE EXAMPLES

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)

MEASURING ENGAGEMENT

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

OTHER MEASURES

  Joined,

not

engaged

Joined,

engaged

Did not

join

Total P-value

for

differen

ce

between

groups

n 15 15 33 63  

Meetings

attended

in 4-

month

follow-up

1.7±1.4 3.7±0.8b 1.8±1.4 2.3±1.5 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.

DEMOGRAPHICS

WHICH MESSAGE TYPE PROMPTED THE

MOST USER ENGAGEMENT?

Poll Request Weight Nutr News/Info

Recipe0

2

4

6

8

10

12

14

16Mean number of poll votes and comments per message type

Sig greater than all, P<0.05

Sig greater than nutr news & recipes, P<0.05

MEAN NUMBER OF COMMENTS AND POLL VOTES PER POST IN RESPONSE TO DIFFERENT TYPES OF COUNSELOR FACEBOOK MESSAGES

Sig greater than nutr news & recipes, P<0.05

F=60.3, P<0.001

Request Poll Nutr News/Info

Recipe Weight0

1

2

3

4

5

6

7

Mean number of likes per message typeSig greater weight, recipe, & nutr news, P<0.05

Sig greater than weight, P<0.05

MEAN NUMBER OF LIKES TO DIFFERENT TYPES OF COUNSELOR FACEBOOK MESSAGES

Sig greater than weight & recipe, P<0.05

F=20.6, P<0.001

Request Poll Nutr News/Info

Recipe Weight12

12.5

13

13.5

14

14.5

15

15.5

16Mean number of views per user by message

type

EXPOSURE TO DIFFERENT TYPES OF COUNSELOR FACEBOOK MESSAGES

P=0.67

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.

RESULTS OF MESSAGE TYPE AND ENGAGEMENT

52%29%

14%

5%

Message preference as reported by participant

Recipes Nutrition news and infoPolls Requests for suggestions

WHICH MESSAGES DID PARTICIPANTS REPORT LIKING THE MOST AT THE

END OF THE STUDY?

No one reported liking the weight posts.

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.

WAS ENGAGEMENT WITH FACEBOOK ASSOCIATED WITH WEIGHT LOSS?

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.

-0.4kg10 posts!

Baseline 2-months

-14

-12

-10

-8

-6

-4

-2

0

Joined, not engagedJoined, engagedDidn't join

WEIGHT LOSS BY 3 ENGAGEMENT LEVELS AT 2 MONTHS

P=0.90

Adjusted for meeting attendance

Poun

ds

lost

Baseline 2-months 6-months

-14

-12

-10

-8

-6

-4

-2

0

Joined, not engagedJoined, engagedDidn't join

P=0.008

P=0.90

Adjusted for meeting attendance

WEIGHT LOSS BY 3 ENGAGEMENT LEVELS AT 6 MONTHS

Sig diff from Didn’t join and Joined, engaged P<0.01

Poun

ds

lost

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.

CONCLUSIONS