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There are several strengths to the present study. Studies examining social support provided via discussion boards have also found Informational to be a predominant source of support [ 1836 ]. Linear regression analysis was used to examine predictors of Twitter such as prior use of Twitter. African Americans and Hispanics are more likely to be users of Twitter than whites [ 27 ] so Twitter also represents a way to deliver health-related turners to populations that may be difficult to reach. Utilization of these features on weight loss websites is often low with one study reporting only 7.

There has been a wealth of research examining the relationship between social interactions and social support with health outcomes. More details on the content and de of the podcasts can be found elsewhere [ 23 ].

To capture the most objective data, a of actual for to Twitter were used to categorize Active posters, regardless of how participants reported their activities on the weekly surveys. The goal of the online social network was to allow participants to provide each other with social support interactions that are present in face-to-face delivery but adding the possibility of in-the-moment posts and responses. The direction of this relationship cannot be determined in that it is not clear if those who room successful at weight loss were motivated to post to Twitter or posting to Twitter provided a benefit to participants that assisted them in losing weight e.

Some studies have found that increases in social support are related to weight loss [ 33 ] or improvements in weight loss-related behaviors [ 634 ], while others have found no benefit of increasing social support for weight loss outcomes [ 35 ]. Engagement with Twitter was related to weight loss and participants mainly used Twitter to provide Information support to one another through status updates.

Most studies that have examined social support related to remotely delivered weight loss interventions have focused on the utilization of discussion boards [ 141618 ]. The goal of this present analysis was to examine the use of Twitter, the relationship between Twitter engagement and weight loss, and the types of social support provided. Social support has also been shown to be a potentially beneficial component of a weight loss program [ 67 ].

This study investigated what types of social support were utilized, predictors of Twitter engagement, and the relationship looking Twitter engagement and weight loss. It is possible that as the participants felt more comfortable with one another, those two types of support which both represent a conversation with other participants versus posting a simple status update began to emerge more.

Main outcome data, such as body weight, was collected at baseline, 3 months, and 6 months. Tangible assistance was the least used form of social support with no examples of direct tasks, indirect rooms, or active participation observed.

of posts by participant were calculated each week and tallied over the course of the study. Only two social support saw increases from months 0—3 to 3—6. Both groups looking two podcasts per week for 3 months 15 min each and two mini-podcasts per week for months 3—6 5 min each. If none of the chats recorded the same type of social support code then agreement was reached by consensus.

For communication among participants was delivered entirely through Twitter. Several studies have demonstrated a chat between social support and improved health outcomes and health-related behaviors, including smoking cessation [ 2 ], cardiovascular disease prevention [ 3 ], diabetes treatment [ 4 ], and depression [ 5 ]. Several Internet-based weight loss studies have tried to enhance social support by providing participants with access to online discussion forums or chat rooms [ 111415 ]. Therefore, each post was coded as only one type of social support. In the present study, after adjustment for potential confounders, Twitter use was found to predict weight loss.

The text of the Twitter posts was coded by three separate raters for type of social support. To examine the types of online social support utilized in a behavioral weight turner intervention and relationship of posting and weight loss. The Kruskal—Wallis test was used to examine differences in age by tertile of Twitter posts. Future research should explore how the types of social support provided via online social networking sites during a weight loss intervention change over time.

The remaining participants were categorized as neither neither regularly posting to Twitter nor regularly reading the posts. All participants were required to own one of four types of internet-capable mobile devices: iPhone, iPod Touch, BlackBerry, or an Android-based phone. Increasing social support can be an effective way to enhance weight loss outcomes in both traditionally delivered behavioral interventions [ 9 ] as well as those delivered online [ 10 ].

In the present study, not everyone equally engaged with Twitter and active participation decreased over time. The final aim was to examine the types of social support provided on Twitter by participants.

Weight loss social support in characters or less: use of an online social network in a remotely delivered weight loss intervention

Participants were excluded if they were a smoker, had an unstable medical or mental status, history of myocardial infarction or stroke, or uncontrolled thyroid condition, were unable to attend assessments or increase physical activity, were in treatment for alcohol or drug dependency, had an eating disorder, were currently participating in a weight loss program, or were pregnant, breastfeeding, or planning on becoming pregnant within the next 6 months. While prior Twitter use or initial Twitter engagement in this study did not predict overall Twitter use, initial reported weight loss was predictive.

The present study sought to categorize participants as active users Activeusers who did not regularly post to Twitter but read the posts Readersand those who did neither Neither. A study weight loss counselor posted two messages a day to Twitter in order to reinforce messages from the podcasts and stimulate discussion. The main type of support provided within this study was Informational.

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Linear regression analysis was used to examine predictors of weight loss such as engagement with Twitter. The of lurkers in the present study was small but was relatively constant over time.

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This study also sought to assess the type of support delivered via Twitter within a mobile, weight loss program. There was a great deal of variability among participant use of Twitter with a range of 0— total posts per participant.

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There were a total of 2, posts to Twitter over the 6-month study. Providing a way for participants to receive support from one another in a weight loss trial may not only help to improve weight loss but also reduces the time burden on weight loss counselors, who instead rely on fellow study participants to provide much of the interaction that takes place in a behavioral weight loss study [ 8 ]. All analyses were conducted using SPSS For the main trial, 96 overweight adults were recruited to participate in a 6-month study.

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There was an increase in posts providing compliments or demonstrating listening over the 6-month study. Participants could use their existing Twitter or create a user and were told to log on daily to read and post messages so they would receive the content delivered by a weight loss counselor and fellow participants.

Other researchers have also found that initial weight loss is related to adherence and success within weight loss programs [ 28 ]. There appeared to be a curvilinear relationship between Twitter usage and age with both high and low frequency posters being slightly younger than medium posters. Weight loss analyses were conducted using intent-to-treat by baseline observation carried forward. There are sub-types of each type of major source of support.

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One of the most frequent types of teaching posts was a status update about the participant that was not in response to anything else posted but was a statement about what the participant did or planned to do providing new facts, e. This finding demonstrates the need for future studies to explore who benefits most from participating in online social networks and tailoring the method of social support delivery at the beginning of an intervention, perhaps giving participants a choice of support delivery methods.

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If two of the three raters agreed on the type of support, that type of support was used to categorize the post. It is possible that Twitter produced a level of social comparison—such that participants who were successful with weight loss were active posters, leading less successful participations to discontinue posting.

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Few studies have examined the use of Web 2. The study coordinator did not participate in discussions initiated by participants, allowing for the potential for this type of intervention to be fully automated. Each week, posts to Twitter were saved for analysis. The literature surrounding the relationship of social support with weight loss has been mixed [ 32 ].

This is similar to other studies that employed electronic forms of message delivery, finding utilization of these sources of support declines over time [ 1115 ]. Another study utilizing a website for weight loss found that the social support sections of the website were the least utilized and received the lowest ratings of satisfaction from participants [ 14 ]. More detailed information on the study methods can be found elsewhere [ 21 ]. Posts to Twitter and type of Twitter involvement active, reader, or neither is presented in Table 2. This weight loss study allowed for an in-depth examination of the interactions that took place among a group of people who were all actively receiving a behavioral weight loss program.

Additional outcomes of the main trial are presented elsewhere [ 21 ]. The types of support offered during the study, of posts by category, and examples of each type are presented in Table 3. The first aim was to examine Twitter engagement. The internet has been used effectively to deliver behavioral weight loss interventions [ 11 — 13 ].

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A University Institutional Review Board approved the study and all the participants gave written informed consent. Structural social support, or the availability of social support [ 8 ], can be categorized into several forms such as informational, tangible, esteem, network, and emotional support [ 17 ].

Participants reported each week by questionnaire if they posted to Twitter, only read Twitter, did both, or did neither. Those who posted to Twitter at least once per week were categorized as active. What is evident is that participation in the online social network was beneficial to some participants.

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People who are socially isolated have been shown to have poorer health outcomes and higher rates of mortality than those who are more socially engaged with others and have sustaining social relationships [ 1 ]. All data were collected and analyzed between and There were three primary aims of the statistical analyses as part of this paper. The study was able to capture lurkers who primarily read posts by utilizing information from weekly surveys.

Next, the relationship between Twitter engagement and weight loss was explored. Esteem support seeks to make someone feel better by complimenting complementvalidating feelings validationor relieving blame of an individual relief of blame [ 17 ]. Posts and responses to Twitter posts were ificantly lower during the 3—6-month time frame as compared to the 0—3-month time frame.

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While many similar social support studies have used two raters [ 18 ], the addition of a third rater in the present study allowed an additional way to reach consensus e. Network support occurs when someone offers access to new friends accessshows willingness to be with the person presenceor highlights the availability of others within the social network companions [ 17 ]. Type and frequency of social support used during a mobile weight loss intervention using Twitter. The present study examined the role an online social networking site played with promoting weight loss and social support in a virtual health community [ 25 ] as part of a 6-month randomized clinical trial.

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The second aim was to examine the relationship between Twitter engagement and weight loss. Research has shown that viewing profiles of successful or attractive people within a social network can lead to feelings of inadequacy and greater feelings of negative body image [ 29 ]. Little is known about how online social networking can help enhance weight loss.