A culturally sensitive approach to obesity for Spanish speakers in Latin America, Spain, and the United States using Noom: A behavioral lifestyle intervention

Abstract

Abstract Objective: To test the effectiveness of Noom for Spanish-Speakers in losing a clinically significant (≥ 2.5%) weight in 16 weeks and examine differences by country Participants and Methods: This study is a retrospective, observational design to test the effectiveness of a mHealth intervention for Spanish-Speakers (n= 1,531) who were overweight or obese. Participants were included from 5 countries: Argentina (n=161), Spain (n= 383), Mexico (n=326), Chile (n= 103), and the United States (n=558) and were majority female (98%). The intervention was Noom, a mHealth behavior change program. Weight was the primary outcome of our study. The duration of the intervention is 16 weeks. Results: Time was found to be a significant predictor of weight at Weeks 8 and 16, where Noom users lost 1.67 kg at week 8 and 1.79 kg at week 16 (baseline vs week 8: B=–1.67, 95% CI –1.85 to –1.50; baseline vs week 16: B=–1.79, 95% CI –2.09 to –1.48). Total weight loss for starters was 1.8 kg (SD= 0.0) or 2.2% of their body weight at Week 16. Both individual and group engagement were found to be predictors of weight at Weeks 8 and Weeks 16, such that as engagement increased by 1 composite score, weight decreased by 0.33 kg (baseline vs week 16: B=–.33, 95% CI –0.45 to –0.21) and 0.46 kg (baseline vs week 16: B=–.46, 95% CI –0.73 to –0.20), for individual and group engagement respectively at Week 16. Language adaptation was not found to be a significant predictor of weight, F(2,687.38) = 1.29; p=.275. In addition, country of origin was not a significant predictor of weight (p=.159). Conclusions: mHealth interventions can assist Hispanic individuals of various countries in producing a modest amount of weight. Adaptation may not be necessary for users to benefit, highlighting the utility of using mHealth interventions on a global scale. Future research is needed to address barriers to engagement.