Directive and nondirective e-coach support for weight loss in overweight adults
Open accessAbstract
BACKGROUND: Although e-coach support increases the effectiveness of Internet weight loss interventions, no studies have assessed influence of type of e-coach support. PURPOSE: The effects of nondirective (collaborative, flexible) and directive (prescriptive, protocol driven) e-coach support on weight loss, dietary behavior, physical activity, and engagement were assessed in a 12-week weight loss e-coaching program. PROCEDURES: Overweight adults (N = 104) were randomly assigned to nondirective, directive, or minimal support. All received weekly lessons and feedback graphs via e-mail. Participants in the nondirective and directive support conditions received individualized nondirective or directive weight loss support. RESULTS: For females, weight loss (η(2) = 0.10) and changes in waist circumference (η(2) = 0.07) were greater in the directive than in the nondirective and minimal support conditions. CONCLUSIONS: Differences in type of e-coach support are salient to participants. Directive support is beneficial to females in a 12-week e-coach weight loss program.
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In Gabriele 2011, all participants received an Internet-based weight loss program with weekly lessons and feedback delivered by e-mail, and were randomized to no individualized support, directive e-mail coaching, or non-directive e-mail coaching.
“In Gabriele 2011, all participants received an Internet-based weight loss program with weekly lessons and feedback delivered by e-mail. Participants were randomized to one of three groups: no individualized support, directive e-mail coaching or non-directive e-mail coaching.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
In Gabriele 2011 participants were reported to be blinded to treatment condition.
“In Gabriele 2011 participants were reported to be blinded to treatment condition.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
All analyses incorporating the Gabriele trial showed high heterogeneity.
“All analyses incorporating the Gabriele trial showed high heterogeneity, however.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
At three months, participants receiving individualized feedback lost more weight than participants receiving no additional feedback (MD −2.1 kg, 95% CI −2.9 to −1.4; P < 0.00001; 352 participants; three trials).
“At three months, participants receiving individualized feedback lost more weight than participants receiving no additional feedback (MD −2.1 kg (95% CI −2.9 to −1.4); P < 0.00001; 352 participants; three trials; Analysis 3.1; main comparison 3.1.1).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
At three months, a similar percentage weight loss was observed for e-mail feedback, including directive e-mail coaching in Gabriele 2011 (MD −2.7%, 95% CI −4.7 to −0.6; P = 0.01; 180 participants; two trials).
“When types of feedback or support were examined separately, a similar percentage weight loss was observed for e-mail feedback, including the directive e-mail coaching in the Gabriele 2011 trial (MD −2.7% (95% CI −4.7 to −0.6); P = 0.01; 180 participants; two trials; Analysis 3.4: subgroup analysis 3.4.2)”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
Non-directive e-mail coaching as conducted in Gabriele 2011 did not result in greater weight loss (MD −0.2%, 95% CI −2.3 to 2.0; P = 0.89; 69 participants; one trial).
“Meanwhile, non-directive e-mail coaching as conducted in the Gabriele 2011 trial did not result in greater weight loss (MD −0.2% (95% CI −2.3 to 2.0); P = 0.89; 69 participants; one trial; Analysis 3.4: secondary comparison 3.4.4).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
At three months, e-mail counseling produced a greater weight loss (MD −2.3 kg, 95% CI −3.1 to −1.5; P < 0.00001; 291 participants; three trials).
“The effect was slightly greater for e-mail counseling (MD −2.3 kg (95% CI −3.1 to −1.5); P < 0.00001; 291 participants; three trials; Analysis 3.1; subgroup analysis 3.1.2)”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
At three months, non-directive e-coaching was not effective for waist circumference (MD −0.3 cm, 95% CI −2.8 to 2.2; P = 0.80; 69 participants; one trial).
“however non-directive e-coaching was not effective (MD −0.3 cm (95% CI −2.8 to 2.2); P = 0.80; 69 participants; one trial; Analysis 3.8: secondary comparison 3.8.2).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
The authors of Gabriele 2011 found more differences between the directive and non-directive intervention arms than between either arm and the control intervention.
“Furthermore, the authors found more differences between the directive and non-directive intervention arms than between either arm and the control intervention.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
At three months, participants receiving individualized feedback or support lost a greater percentage of their body weight (MD −2.5%, 95% CI −4.1 to −0.9; P = 0.003; 227 participants; two trials).
“At three months, participants receiving individualized feedback or support lost a greater percentage of their body weight (MD −2.5% (95% CI −4.1 to −0.9); P = 0.003; 227 participants; two trials; Analysis 3.4: main comparison 3.4.1).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
The analyses combining Gabriele 2011 and Tate 2006 showed moderate to high heterogeneity (I2 = 49% and I2 = 66%).
“However, the analyses combining Gabriele 2011 and Tate 2006 showed moderate to high heterogeneity (I2 = 49% and I2 = 66%), as the Gabriele trial consistently showed a smaller effect size than the Tate trial.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
Non-directive e-mail counseling did not appear effective for weight loss (MD −0.3 kg, 95% CI −2.2 to 1.7; P = 0.80; 69 participants; one trial).
“Non-directive e-mail counseling did not appear effective (MD −0.3 kg (95% CI −2.2 to 1.7); P = 0.80; 69 participants; one trial; Analysis 3.1; secondary comparison 3.1.4).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
At three months, participants in e-counseling or directive e-coaching had a greater reduction in mean waist circumference compared to control groups (MD −2.6 cm, 95% CI −4.0 to −1.2; P = 0.0003; 160 participants; two trials).
“At three months, compared to the participants in the control group, participants in e-counseling or directive e-coaching had a greater reduction in mean waist circumference compared to participants in the control groups (MD −2.6 cm (95% CI −4.0 to −1.2); P = 0.0003; 160 participants; two trials; Analysis 3.8: main comparison 3.8.1)”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Gabriele 2011
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- Authors
- Gabriele, J. M., Carpenter, B. D., Tate, D. F., & Fisher, E. B.
- Affiliations
- University of Mississippi Medical Center (US)
- Washington University in St. Louis (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Gabriele, Jeanne Marisa
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-11-25
- Volume
- 41
- Issue
- 2
- Pages
- 252-263
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC3891570
- OpenAlex
- W2149928947
- Cited by
- 77
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 11 · 2017: 5 · 2016: 7 · 2015: 5 · 2014: 9 · 2013: 4 · 2012: 3
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007456)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- e-coaching, weight loss, overweight adults, dietary behavior, physical activity, user engagement, gender differences, waist circumference
- MeSH terms
- Adult, Behavior Therapy, Feeding Behavior, Female, Humans, Male, Middle Aged, Motor Activity, Patient Compliance, Sex Characteristics, Therapy, Computer-Assisted, Weight Loss, Electronic Mail, Overweight, Waist Circumference
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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