Effects of a behavior-based weight management program delivered through a state cooperative extension and local public health department network, North Carolina, 2008-2009.

INTRODUCTION: Eat Smart, Move More, Weigh Less (ESMMWL) is an adult weight management program developed in response to North Carolina Obesity Plan recommendations to make weight management interventions accessible to underserved populations. ESMMWL was designed to be delivered through the North Carolina Cooperative Extension and North Carolina Division of Public Health. Program coursework included content on evidence-based eating and physical activity behaviors and incorporated mindful eating concepts. The objectives of this study were to describe participant changes in weight and behaviors and to document the effectiveness of the program. METHODS: In this prospective pilot study, courses were delivered and data collected from January 2008 through June 2009. Instructors provided feedback about implementation. For participants, height, weight, and waist circumference were measured at baseline and completion. Participants completed a questionnaire about changes in their eating and physical activity behaviors, changes in their confidence to engage in weight management behaviors, and their satisfaction with the course. RESULTS: Seventy-nine instructors delivered 101 ESMMWL courses in 48 North Carolina counties. Most of the 1,162 completers were white women. Approximately 83% reported moving toward or attaining their goal. The average weight loss was 8.4 lb. Approximately 92% reported an increase in confidence to eat healthfully, and 82% reported an increase in confidence to be physically active. Instructors made suggestions for program standardization. CONCLUSION: This study demonstrated the effectiveness, diffusion, and implementation of a theoretically based weight management program through a state extension and local public health department network. Study of the sustainability of changes in eating and physical activity behaviors is needed.

How primary care providers might review evidence on hydration.

Primary care providers (PCPs) are increasing their use of evidence-based medicine (EBM) in the care they give patients. They evaluate the available evidence to determine if it applies to their patients and seek to complement their clinical experience with EBM to improve patient outcomes. In evidence-based practices, patient oriented data are valued more highly than disease oriented evidence. More than 8 million biomedical articles are published annually, but only an estimated 2% of those are relevant to improved patient outcomes (POEMs - patient oriented evidence that matters). This paper describes some of the tools used by PCPs to search for evidence and the decision-making process used to determine if they will change their practice. Understanding how PCPs evaluate research findings and other evidence can help hydration researchers frame their research questions and study reports.

Healthy Eating: Defining the Nutrient Quality of Foods.

Today, many initiatives to promote healthy eating and physical activity focus on changing policy and the environment to improve the health, not only of motivated or high-risk individuals but also the entire population. The escalating rates of overweight/obesity and incidence of diet-related diseases/health conditions will require many interventions to influence change. Those wishing to affect policy and environmental changes are often faced with defining foods and beverages that meet criteria defined as "healthy."