Lifestyle Modification for Weight Reduction With Peer Support Among Adults in an Urban Slum of Karachi, Pakistan
Condition: Weight Loss
MeSH terms: Body Weight; Weight Loss
Study type: Interventional

Summary: 
      The feasibility study was conducted using a mixed-methods single group, pre and post-test
      design (Quasi experiment) approach. The investigator assessed if a weight reduction program
      using WhatsApp and peer support would work well enough to conduct a larger study. The
      investigator conducted the study in an urban slum (Azam Basti) in Karachi, Pakistan and
      enrolled 50 participants, along with participant nominated peers from the same family.
      Initial eligibility was assessed over the phone. Those who met the initial eligibility were
      visited to assess eligibility in terms of BMI (23 kg/m2 and above). Height was measured in
      centimeters (cm) and weight in kilograms (kgs) using a digital weighing scale. Both values
      were entered into the web-based calculator to calculate BMI. Participants with a BMI of 23
      kg/m2 and above were enrolled and written informed consent was obtained. The participants
      then nominated one peer from the family. Peer eligibility was assessed and written informed
      consent was obtained. Once the participants and peers were enrolled in the study, the
      baseline assessments were completed. During the baseline assessments, participants were
      interviewed for sociodemographic and health-related information, 24-hour dietary recall, and
      Global Physical Activity Questionnaire (GPAQ). Peers were also interviewed for
      sociodemographic information. After the baseline assessment, the participants and peers
      received lifestyle modification education through WhatsApp voice calls for three days and
      then once monthly for one year delivered by a trained nutritionist. The intervention was
      delivered mostly in groups. The peer-supported lifestyle modification intervention was
      developed with the aim of helping participants adopt healthier lifestyles by making dietary
      changes, increasing physical activity, and achieving a weight loss goal of 5% of their
      initial body weight. Additionally, the intervention aimed to prevent weight gain among
      participants. The participants were followed-up for one year. Participants weight (kg), diet
      through 24-hour dietary recall, and physical activity through Global Physical Activity
      Questionnaire (GPAQ) were assessed every month. Social support questionnaire was also asked
      from participants at 3, 6, 9, and 12 months. The investigator also conducted in-depth
      interviews at the end of the study with study participants and peers to understand the
      barriers, facilitators, and experiences of the lifestyle modification intervention program.
    


Intervention name(s): Peer-supported, WhatsApp-assisted lifestyle modification intervention
Intervention type(s): Behavioral
Intervention description(s): The lifestyle modification intervention, supported by peers and WhatsApp voice calls aimed to assist participants in making dietary modifications, increasing physical activity, and achieve a weight loss of 5% of their initial body weight as well as avoid weight gain. A trained nutritionist delivered the intervention after the baseline assessment individually or in groups that covered six sessions related to dietary modifications, physical activity, set-up goals and action plans, and peer assignments and then once monthly for a year using WhatsApp voice calls to the participants and peers.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Lifestyle modification; Peer support; Weight reduction; Slums; WhatsApp; Mixed-methods