MON-871 - Exposure of A Lifestyle Intervention on Weight Loss, Metabolic Syndrome, and Lifestyle Habit Changes

Objectives: The study examined the effectiveness of a group-based intervention on weight loss, metabolic syndrome (MetS) status, and behavioral changes relative to class attendance among individuals with MetS.

Methods: This ancillary study utilized data from the Enhancing Lifestyles in Metabolic Syndrome (ELM) trial, a 24-month lifestyle intervention for adults with MetS recruited from five U.S. sites between 2019-2022. The intervention was delivered through group-based weekly classes with a structured curriculum for the first 6 months, followed by biweekly to monthly meetings for the remainder of the follow-up. Outcomes included changes in weight, MetS severity and remission, and behavior measures including physical activity, perceived stress, eating competence, and dietary intake which were collected at baseline, 6 months, 15 months, and 24 months. Chi-square and independent-samples tests, in addition to regression analyses and generalized linear models with a gamma distribution and log link were used for the analyses.

Results: Among 306 participants in the group-based intervention, majority were female, White, married, employed, had no children, and had at least one working car. Participants attended an average of 19 out of 37 classes (52%); 19 participants did not attend any classes. At 6 and 24 months, participants who worried about neighborhood physical safety and those who were working had significantly lower attendance rates (P < 0.05). A baseline preference for group-based delivery was significantly associated with higher class attendance at 6 months (IRR = 1.14, p = ≤ 0.05) and 24 months (IRR = 1.19; p = 0.03). Participants with one or more working cars had significantly lower attendance rates at 6 and 24-months (P < 0.05) compared to those with no working cars. While class attendance was not significantly associated with weight change or MetS outcomes, attending the first 4 classes was significantly associated with increased perceived stress (p = 0.023) and slightly decreased fruit and vegetable intake (p = 0.02) at 6 months. However, by the end of the treatment at 24 months, these participants showed significantly reduced perceived stress (p = 0.012) and improved eating-related behavior (p < 0.001).

Conclusions: Findings from the study indicated employment status, neighborhood safety concerns, transportation access, and intervention preferences influenced class attendance in the group-based ELM intervention. Although attendance did not show effects on weight or metabolic outcomes, early engagement such as attending the first 4 classes, was linked to sustained behavioral improvements. Strategies, such as flexible scheduling, tailored formats (group vs individual vs virtual), and preference-based assignment, may enhance participation and outcomes in group-based lifestyle interventions.

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