Developing a Weight Management Class as a Recruitment Tool for an Online Weight Loss Program to Rural Illinois Residents

The purpose of this study is to identify how to maintain a sustainable collaboration Illinois Extension Nutrition and Wellness Educators while continuing to offer an online weight-loss program, EMPOWER, to rural Illinois residents.

* The primary aim of the study is to determine if an Extension-delivered introductory weight management class will be successful in recruiting rural individuals interested in losing weight to the EMPOWER weight-loss program.
* The secondary aim is to enroll interested rural participants in an online weight loss intervention that focuses on promoting dietary and lifestyle behavioral changes to achieve ≥5 percent weight loss.

Participants who participate in the EMPOWER weight-loss intervention will:

1. Complete 12 online educational sessions over a 3-month period followed by a 9-month follow-up period.
2. Participate in daily self-weighing using a provided WiFi-enabled scale.
3. Will have a monthly nutrition coaching call once per month for the 12-month duration of the study.
4. Will complete food records and self-report waist and hip circumference measures at baseline, 3-months, and 12-months.

The purpose of our study is to identify how to maintain a sustainable collaboration with our lab's weight-loss program, EMPOWER, and rural Illinois Extension Nutrition and Wellness Educators. We are aiming to identify potential barriers of recruitment, rolling enrollment, and intervention methods to enhance the success of maintaining this collaboration at a distance and continue to offer our services to rural areas. If we can demonstrate continual, successful collaboration with the Extension educators, we can work towards expanding EMPOWER to even more communities. In objective 1, we will create an introductory weight management curriculum in collaboration with three Illinois Extension nutrition and wellness educators that can be disseminated to their respective rural populations (Christian, Jersey, Macoupin, Montgomery, Jo-Daviess, Stephenson, Clark, Crawford, and Edgar counties). The class will also be supplemented with healthy recipe handouts. The class serves to fulfill curricula requirements for Extension educators in the area of chronic disease prevention and management while simultaneously serving as a recruitment method for our lab's EMPOWER program. This objective serves to answer the research question of whether offering a weight management class through Extension is a feasible way to recruit those in need of weight-loss to EMPOWER while maintaining long-term collaboration with Extension. The data obtained from this objective includes an exit interview with each of the Extension educators, the number of attendees from each Extension class, as well as an optional survey provided to the Extension class attendees. No identifiable information will be obtained from the Extension class attendees unless they express interest in our recruitment flyer and proceed to fill out an eligibility form. Objective 2 of our study is to enroll interested rural participants into a 3-month intervention and 9-month follow-up EMPOWER weight loss trial with statistically significant weight-loss being the expected outcome at the end of the 12 months. EMPOWER is an online weight-loss program that aims to achieve safe weight-loss through sustainable dietary and lifestyle changes. Participants of EMPOWER will be provided online educational materials through Illinois eText and nutrition coaching from registered dietitians and nutrition students via email/text correspondence and monthly phone/video calls. Participants will be asked to self-weigh everyday as a method to monitor energy balance. MealPlot, a web-application developed by our lab, will be available for participants to submit food records, message their coach, see their weight data, and monitor their protein and fiber intake. Overall, successful EMPOWER recruitment from the Extension class and following success of EMPOWER enrollees losing statistically significant weight would lead to an improvement of health among rural residents where weight care strategies are typically limited and would demonstrate the feasibility of long-term collaboration with Extension educators.

Eligibility Criteria:
Inclusion Criteria:

* BMI greater than or equal to 28 kg/m\^2
* age 18-75
* ability to access the internet and smartphone
* fluent in English
* having primary residence in a rural Illinois county

Exclusion Criteria:

* Pregnant or lactating
* previous or planned bariatric surgery
* BMI less than 28 kg/m\^2
* Age less than 18 or greater than 75
* no access to internet and smartphone/smart device
* on GLP-1 Receptor Agonist weight loss medication
* Diagnosed with an eating disorder