Publications by authors named "Rebecca J Brouwer"
Objective: To present the short-term follow-up findings of the Steps to Health study, a randomized trial to evaluate the effectiveness of two employee weight management programs offered within Duke University and the Health System.
Methods: A total of 550 obese (body mass index, ≥30 kg/m2) employees were randomized 1:1 between January 2011 and June 2012 to the education-based Weight Management (WM) or the WM+ arm, which focused on behavior modification. Employees were contacted to complete a follow-up visit approximately 14 months after baseline.
Few studies have assessed physical activity at multiple time points in the postpartum period or used both self-reported and objective measures of assessment. The purpose of this study was to describe physical activity and sedentary behavior at two time points in a cohort of overweight or obese postpartum women using both self-reported and objective measures. In total, 132 women completed physical activity assessments at a median of 24 weeks postpartum and again approximately 10 months later.
View Article and Find Full Text PDFBackground: The workplace can be an important setting for addressing obesity. An increasing number of employers offer weight management programs.
Purpose: Present the design, rationale and baseline characteristics of the Steps to Health study (STH), a randomized trial to evaluate the effectiveness of two preexisting employee weight management programs offered at Duke University and Medical Center.
Background: The American Academy of Pediatrics (AAP) has issued specific behavioral recommendations to prevent obesity. It is unclear how often high-risk preschoolers and overweight mothers meet recommended behavior goals and whether meeting these goals is negatively associated with overweight/obesity.
Objective: To describe the proportion of preschoolers and mothers that meet AAP-recommended behavior goals and examine the associations of meeting goals with weight-status, and mothers meeting goals and children meeting corresponding goals.
Background: Postpartum weight retention is a risk factor for long-term weight gain. Encouraging new mothers to consume a healthy diet may result in weight loss.
Objective: To assess predictors of diet quality during the early postpartum period; to determine whether diet quality, energy intake, and lactation status predicted weight change from 5 to 15 months postpartum; and to determine whether an intervention improved diet quality, reduced energy intake, and achieved greater weight loss compared with usual care.
Objective: The study presents the immediate post-intervention results of Kids and Adults Now - Defeat Obesity!, a randomized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler (2-5 years old) dyads in North Carolina (2007-2011). The outcomes include change from baseline in the child's diet, physical activity and weight, and in the mother's parenting behaviors, diet, physical activity, and weight.
Method: The intervention targeted parenting through maternal emotion regulation, home environment, feeding practices, and modeling of healthy behaviors.
While the prevalence, comorbidity, risk profile and health care utilization for late-life depression have been described for many Western countries, much less is known about the recent epidemiology of late-life depression in East Asian countries such as Korea. We investigated predictors for depressive symptoms and the association between depressive symptoms and the utilization of both medical care and preventive services in elderly Koreans. Data were obtained from a nationally representative sample of Koreans aged 60 and above (2226 men, 2911 women) who participated in the 2008 wave of the Korean Longitudinal Study of Ageing.
View Article and Find Full Text PDFBackground: Physician counselling may help patients increase physical activity, improve nutrition and lose weight. However, physicians have low outcome expectations that patients will change. The aims are to describe the accuracy of physicians' outcome expectations about whether patients will follow weight loss, nutrition and physical activity recommendations.
View Article and Find Full Text PDFIntroduction: Few studies have examined the correlates of objectively measured amounts of sedentary time and physical activity in young children. We evaluated the demographic, biological, behavioral, social, and environmental correlates of the amount of sedentary time and moderate-to-vigorous physical activity (MVPA) as measured by accelerometry in preschool-aged children.
Methods: We obtained baseline measurements of physical activity by using an Actical accelerometer among 337 preschool-aged children (aged 2-5) of overweight or obese mothers.
Background: In the United States, about two thirds of women of reproductive age are overweight or obese. Postpartum is a transitional period. Life changes during this time can put mothers under high levels of stress when interpersonal support is inadequate.
View Article and Find Full Text PDFObjective: Evidence suggests that physicians' use of motivational interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' used MI techniques.
Methods: Forty primary care physicians and 461 of their overweight or obese patients were audio recorded and surveyed.
Objective: Examine primary care physicians' use of counseling techniques when treating overweight and obese patients and the association with mediators of behavior change as well as change in nutrition, exercise, and weight loss attempts.
Methods: We audio recorded office encounters between 40 physicians and 461 patients. Encounters were coded for physician use of selected counseling techniques using the Motivational Interviewing Treatment Integrity (MITI) scale.
Background: Prevention of childhood obesity is a public health priority. Parents influence a child's weight by modeling healthy behaviors, controlling food availability and activity opportunities, and appropriate feeding practices. Thus interventions should target education and behavioral change in the parent, and positive, mutually reinforcing behaviors within the family.
View Article and Find Full Text PDFBackground: Weight gain in the postpartum period is a risk factor for long-term obesity. Investigations of dietary intake among lactating and nonlactating overweight women might identify nutritional concerns specific to this population.
Objective: To compare nutrient, meal, and snack intakes, food-group servings and prevalence of dieting among fully breastfeeding (BF), mixed breast and formula feeding (MF), and formula feeding (FF) overweight and obese women.
Background: Physicians are encouraged to counsel overweight and obese patients to lose weight.
Purpose: It was examined whether discussing weight and use of motivational interviewing techniques (e.g.
Smoking prevalence in early pregnancy: comparison of self-report and anonymous urine cotinine testing.
J Matern Fetal Neonatal Med
January 2011
Objective: Societal pressures against smoking during pregnancy may lead to a reduction in disclosure of smoking status. The objective of this study was to compare prevalence of smoking at prenatal intake by self-report with anonymous biochemical validation.
Methods: Women receiving care at the Duke Obstetrics Clinic from February 2005 through January 2006 were eligible for evaluation.
Background: Pregnancy may contribute to overweight and obesity.
Purpose: The primary objective of Active Mothers Postpartum was to promote a reduction in BMI through 24-months postpartum via sustainable lifestyle changes.
Design: Behavioral intervention RCT to enhance postpartum weight loss.
Active Mothers Postpartum (AMP): rationale, design, and baseline characteristics.
J Womens Health (Larchmt)
December 2008
Background: Pregnancy and the postpartum period have been suggested as important contributors to overweight and obesity among women. This paper presents the design, rationale, and baseline participant characteristics of a randomized controlled intervention trial to enhance weight loss in postpartum women who entered pregnancy overweight or obese.
Methods: Active Mothers Postpartum (AMP) is based on the rationale that the birth of a child can be a teachable moment.
Purpose: This study explores how weight-related topics are discussed between physicians and their overweight and obese female patients.
Methods: We surveyed and audio-recorded preventive health and chronic care visits with 25 overweight and obese female patients. We coded both for quantity (content and time) of weight-related discussions and quality (adherence to Motivational Interviewing [MI] techniques).
Background: This study examines whether adding nicotine replacement therapy (NRT) to cognitive-behavioral therapy (CBT) for pregnant smokers increases rates of smoking cessation.
Methods: An open-label randomized trial (Baby Steps, n=181) of CBT-only versus CBT+NRT (choice of patch, gum, or lozenge; 1:2 randomization) was used. Data were collected from 2003 through 2005; analyses were conducted in 2006 and 2007.
Purpose: Physicians are expected to discuss weight loss with overweight and obese patients. Physicians' beliefs, outcome expectancies, and strategies for addressing weight with patients have not been examined.
Design: Two focus groups of family physicians and internists included questions about obesity and how physicians discuss weight loss with patients.