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Health Serv Res. 2018 Dec;53(6):4268-4290. doi: 10.1111/1475-6773.13043. Epub 2018 Sep 23.

Does Effectiveness of Weight Management Programs Depend on the Food Environment?

Author information

1
Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL.
2
College of Nursing, University of Illinois at Chicago, Chicago, IL.
3
School of Public and Environmental Affairs, Indiana University Bloomington, Bloomington, IN.
4
Jesse Brown VA Medical Center, Chicago, IL.
5
College of Medicine, University of Illinois at Chicago, Chicago, IL.
6
Department of Sociology and Criminology and Department of Anthropology, The Pennyslvania State University, University Park, PA.
7
School of Public Health, University of Illinois at Chicago, Chicago, IL.

Abstract

OBJECTIVE:

To estimate the causal effects of a population-scale behavioral weight management program and to determine whether the program's effectiveness depends on participants' geographic access to places to purchase healthy and less healthy foods.

DATA SOURCES:

Secondary data from U.S. Department of Veterans Affairs clinical and administrative records (2008-2014), retail food environment measures from commercial databases (2008-2014), and the American Community Survey (2009-2014).

STUDY DESIGN:

We estimated the effect of the VA's MOVE! weight management program on body mass index after 6 months using difference-in-difference regressions to compare participants with a propensity score-matched control group. We estimated treatment effects overall and in subgroups with different access to supermarkets, fast-food restaurants, and convenience stores.

PRINCIPAL FINDINGS:

MOVE! reduced BMI by about 0.71 units among men and 0.70 units among women. The program was slightly less effective for men living near fast-food restaurants or convenience stores. We found no evidence that treatment effects varied with the food environment among women.

CONCLUSIONS:

The residential food environment modestly alters MOVE! effectiveness among men. A greater understanding of environmental barriers to and facilitators of intentional weight loss is needed. This study highlights important potential intersections between health care and the community.

KEYWORDS:

Obesity; residential environment; retail food outlets; veterans; weight management

PMID:
30246454
PMCID:
PMC6232440
[Available on 2019-12-01]
DOI:
10.1111/1475-6773.13043
[Indexed for MEDLINE]

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