JMIR Publications

ABSTRACT

Background:

Although Latino men have the highest prevalence (45%) of obesity among all men in the US, traditional weight loss interventions do not engage this hard-to-reach and diverse group. Technology-mediated weight loss interventions may offer advantages given Latinos’ rapidly increasing access to the internet.

Objective:

We examined whether Latino men who were overweight or obese preferred engaging in a weight loss intervention with one of 2 technology-mediated options – live group sessions on videoconference or pre-recorded videos available online – or in-person groups sessions. We also examined whether men differed according to demographic, clinical, employment, cultural, and technology use and access factors across the 3 intervention options chosen. Finally, we assessed whether men who chose a videoconference group attended more sessions than men who chose an in-person group.

Methods:

Latino men (n=202, 47.3 ± 11.8 years) were participants in a comparative effectiveness trial based in primary care and randomized to receive the HOMBRE (Hombres con Opciones para Mejorar su Bienestar y Reducir EnfermedadeS cronicas) intervention. HOMBRE was a culturally adapted weight loss intervention offering 3 delivery options with each providing the same evidence-based weight loss sessions. During an orientation session, a trained bilingual coach helped men select one of the 3 intervention options. We used chi-square tests and ANOVA to examine bivariate associations and canonical discriminant analysis for multivariate associations of demographic, clinical, employment, cultural, and technology use and access factors with men’s intervention choice.

Results:

Most Latino men preferred one of the 2 technology-mediated interventions versus a traditional in-person group (60% vs 40%, respectively) with 22% choosing videoconference groups and 38% choosing online videos. For men who selected a group delivery option, 86% attended >25%, 82% attended >50%, and 58% attended >75% of the sessions, with no differences by type of group. Latino men who chose a technology-mediated intervention were more likely to have higher education, be working full or part time, only speak English, be more acculturated, and have computer access than men who chose an in-person group. The canonical discriminant analysis identified 1 orthogonal dimension that distinguished between men who chose an in-person group versus online videos. Participants with a profile of speaking Spanish, being older, using a computer infrequently, having an occupation that requires mostly sitting or standing (relative to having no job), not living with another person, and having less sleep disturbance had a higher probability of choosing an in-person group versus online videos.

Conclusions:

The majority of Latino men offered a choice for weight loss interventions preferred technology-mediated options to in-person groups, especially for educated, English-speaking Latino men with computer access. Providing options that accommodate the diversity of Latino men’s preferences is important for increasing engagement in behavioral interventions. Clinical Trial: NCT03092960