Premium
Does Effectiveness of Weight Management Programs Depend on the Food Environment?
Author(s) -
Tarlov Elizabeth,
Wing Coady,
Gordon Howard S.,
Matthews Stephen A.,
Jones Kelly K.,
Powell Lisa M.,
Zenk Shan N.
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13043
Subject(s) - weight management , computer science , business , medicine , weight loss , obesity
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.