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

Abstract

Objective: 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).

Design: Single-group modified interrupted time series quasi-experimental design whereby participants served as their own controls.

Results: 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 d = 0.74) and 1.44 inches (3.66 cm) (3.58%) waist circumference (Cohen’s d = 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.

Conclusion: 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.

Keywords:

• Women’s health
• physically disabled
• weight loss programs
• virtual systems
• health promotion
• intervention

Acknowledgements

We thank Case Western Reserve University for their generosity and technical assistance provided by Sue Simonson Shick in helping us construct and maintain the GoWoman intervention venue on their Second Life^® island, ClevelandPlus.

Grateful appreciation goes to the dedicated members of the project’s community advisory board, Titilayo Awoniyi, Leanne Beers, Anita Cameron, Terri O’Hare, and Alejandra Ospina, for their involvement in the conceptualization, planning, initial testing, recruitment, implementation, analysis interpretation, documentation, and dissemination phases of this study. We also acknowledge the contributions of research assistants, Rachel Glorsky Stough, Katie Newsome, and Anthony Nguyen.

Disclosure statement

Authors have disclosed no financial conflicts of interest due to commercial associations, consultancies, equity interests, or patent-licensing arrangements in connection with this work.

Additional information

Funding

This study was funded by a field-initiated development grant from the National Institute on Disability, Independent Living, and Rehabilitation Research in the US Department of Health and Human Services (#90IF0036).