Toward the development of self-help health behaviour change programs: weight loss by correspondence.

The goal of this study was to evaluate a correspondence weight control program, and to assess the impact of three program elements (weekly homework, interim weigh-ins, and participation deposits) individually and in combination. All treated participants received 15 weekly standard lessons by mail. Three program features were varied factorially: a) homework assignments, b) interim weigh-ins and c) a deposit refunded contingent on returning homework and/or attending interim weigh-ins. Participants were assigned randomly to active treatment conditions or a delayed treatment control group. Among treated males (N = 14), initial average weight loss and BMI reduction were 9.6 kg and 3.1 respectively; average net weight loss and BMI reduction at one year follow-up were 5.8 kg and 1.9 respectively. Among treated females (N = 128), initial average weight loss and BMI reduction were 3.1 kg and 1.2 respectively; average net weight loss and BMI reduction at one year were 2.3 kg and .88 respectively. Women in all treated groups, except lessons only, showed a greater BMI reduction than untreated controls at the end of treatment. Women in conditions including both homework and interim weigh-ins had greater initial BMI reductions (M = 1.6) than those who received lessons only (M = .76). At one year, net BMI reductions were comparable across all treated groups. Of the 42 women initially registered in conditions that included both homework and weigh-ins, 12 who denied joining other programs lost at least 4.5 kg (M = 7.1) during treatment, and 7 had a net loss of at least 4.5 kg (M = 8.0) at one year without apparent involvement in any other program.

Effects of breast cancer and mastectomy on emotional support and adjustment.

Wortman and Dunkel-Schetter (J. Soc. Issues 35, 120-155, 1979) have argued that victims of misfortune are likely to experience reduced social support at a time when support is needed most. The resulting self-doubt and isolation are thought to increase the victims' distress. Hypotheses derived from their analysis were tested by administering social and emotional adjustment inventories to 301 women who had undergone a mastectomy as treatment for breast cancer, and to 100 women diagnosed as having benign breast lumps (no-cancer, no-mastectomy controls). As expected, perceived emotional support was positively correlated with adjustment. However, contrary to Wortman and Dunkel-Schetter's analysis, the cancer patients perceived greater emotional support from friends and family than did the controls. In addition, these cancer 'victims' were no more socially or emotionally maladjusted than women without cancer.