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Web-based interventions for weight loss and weight maintenance among rural midlife and older women: protocol for a randomized controlled trial

Patricia A Hageman1*, Carol H Pullen2, Melody Hertzog3, Linda S Boeckner4 and Susan Noble Walker2

Author Affiliations

1 Physical Therapy Education, School of Allied Health Professions, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA

2 College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA

3 College of Nursing, University of Nebraska Medical Center, Lincoln, NE, USA

4 Panhandle Research and Extension, University of Nebraska-Lincoln, Scottsbluff, Nebraska, USA

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BMC Public Health 2011, 11:521  doi:10.1186/1471-2458-11-521

Published: 30 June 2011



Weight loss is challenging and maintenance of weight loss is problematic among midlife and older rural women. Finding effective interventions using innovative delivery methods that can reach underserved and vulnerable populations of overweight and obese rural women is a public health challenge.


This Women Weigh-In for Wellness (The WWW study) randomized-controlled trial is designed to compare the effectiveness of theory-based behavior-change interventions using (1) website only, (2) website with peer-led support, or (3) website with professional email-counseling to facilitate initial weight loss (baseline to 6 months), guided continuing weight loss and maintenance (7-18 months) and self-directed weight maintenance (19-30 months) among rural women ages 45-69 with a BMI of 28-45. Recruitment efforts using local media will target 306 rural women who live within driving distance of a community college site where assessments will be conducted at baseline, 3, 6, 12, 18, 24 and 30 months by research nurses blinded to group assignments. Primary outcomes include changes in body weight, % weight loss, and eating and activity behavioral and biomarkers from baseline to each subsequent assessment. Secondary outcomes will be percentage of women achieving at least 5% and 10% weight loss without regain from baseline to 6, 18, and 30 months and achieving healthy eating and activity targets. Data analysis will use generalized estimating equations to analyze average change across groups and group differences in proportion of participants achieving target weight loss levels.


The Women Weigh-In for Wellness study compares innovative web-based alternatives for providing lifestyle behavior-change interventions for promoting weight loss and weight maintenance among rural women. If effective, such interventions would offer potential for reducing overweight and obesity among a vulnerable, hard-to-reach, population of rural women.

Trial Registration NCT01307644