A pilot test of the GoWoman weight management intervention for women with mobility impairments in the online virtual world of Second Life.

Margaret A Nosek, Susan Robinson-Whelen, Tracey A Ledoux, Rosemary B Hughes, Daniel P O'Connor, Rebecca E Lee, Rebecca Goe, Stephanie L Silveira, Rachel Markley, Thomas M Nosek

Journal: Disability and rehabilitation 2020;41(22):2718-2729

PMID: 29889580

Abstract

Pilot test GoWoman, a small-group weight management intervention for mobility impaired women that was a disability- and gender-responsive adaptation of the Diabetes Prevention Program delivered in the online virtual world of Second Life. Objectives were to (1) examine pre-/post-intervention differences in weight, waist circumference, diet, physical activity, self-efficacy for diet and physical activity, nutrition knowledge and social support for weight management, (2) determine intervention feasibility (fidelity, attrition, engagement, acceptability). Single-group modified interrupted time series quasi-experimental design whereby participants served as their own controls. Thirteen women attended ≥8 of 16 GoWoman weekly sessions and lost an average of 5.97 pounds (2.71 kg) (3.31%) body weight (Cohen's  = 0.74) and 1.44 inches (3.66 cm) (3.58%) waist circumference (Cohen's  = 0.83). There were significant improvements in physical activity, diet and self-efficacy for diet and physical activity. All benchmarks for feasibility were met. Ratings of intervention content, group interactions and support and virtual world experiences were highly positive. Findings suggest that a disability- and gender-responsive weight management intervention with peer group support delivered in an online virtual world is feasible, meaningful and may assist with weight management for mobility impaired women. Implications for Rehabilitation This study addresses a gap in the general and rehabilitation research literature by addressing the disproportionately high rates of obesity among women with mobility impairments, who are generally excluded from tests of weight management interventions if they have limited ability to engage in vigorous physical activity. The GoWoman program is an adaptation of the Diabetes Prevention Program Lifestyle Change curriculum that is tailored to meet the unique weight management needs of women with mobility impairments, and was created to become a publicly available, disability- and gender-responsive intervention that can be used in community and rehabilitation settings. More rehabilitation and health promotion program should be offered in the free, online, virtual world of Second Life since participants in this pilot study offered many favorable comments about the new learning and social opportunities available to them there and they did not have to deal with the disability-related environmental and health challenges that often prevent them from participating in face-to-face workshops. Preliminary indications of improvements in body weight, waist circumference, diet and physical activity after attending the GoWoman weight management intervention offered in Second Life tell us that these strategies are feasible for helping women with mobility impairments manage their weight and should undergo further testing.

Address: Department of Physical Medicine and Rehabilitation, Center for Research on Women with Disabilities, Baylor College of Medicine , Houston , TX , USA.; TIRR Memorial Hermann , Houston , TX , USA.; Department of Health and Human Performance, Texas Obesity Research Center, University of Houston , Houston , TX , USA.; Rural Institute for Inclusive Communities, University of Montana , Missoula , MT , USA.; Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University , Phoenix , AZ , USA.; School of Medicine, Case Western Reserve University , Cleveland , OH , USA.
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