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Īlthough mortality associated with obesity has declined over the last three decades in NZ, the rate of decline has been slower among Māori and Pacific Island populations. Behavioural therapy, including techniques such as self-monitoring, stimulus control, goal-setting, problem-solving, relapse prevention, cognitive restructuring and motivation enhancement are believed to improve adherence to behavioural change interventions. Ĭhanging and controlling dietary behaviours and increasing physical activity, is the primary lifestyle treatment recommended for obesity. In 2012–2014, Māori people were more than 1.5 times as likely as non-Māori people to be hospitalised for CVD. Cardiovascular disease (CVD) is experienced disproportionately also. These ethnic inequalities are reflected in excess incidence and mortality rates for Pacific and Māori populations in several obesity-related cancers and greater prevalence of diabetes (11.4% for Pacific males and 11.6% for females 8.2% among Māori men and 7% for females versus 3% for NZ European/Other males and 2.2% for females). NZ resident Pacific and Māori (indigenous) people, who are over-represented among the most deprived, have disproportionately high rates of obesity (68.7 and 50.2% respectively) compared to the European population (30.5%). New Zealand (NZ) has a high prevalence of obesity which varies by deprivation level and ethnicity. Rates of obesity (having a BMI of 30 or over) are increasing worldwide. Further research is needed on how to increase retention. The findings however, are limited by missing data and high drop out of individuals and whole teams. This study suggests that participants in a competition will perform incentivised tasks. Incentives offer a promising strategy for encouraging retention in weight loss interventions. The behaviour goals appeared to have theoretical merit in that more members of high performing teams experienced a positive change in their ABSI. No difference in performance between goals was found suggesting they were equally viable, though tasks worth less points were performed more frequently. Adherence was highest during the first 8 weeks. Of 19 teams ( N = 130) who began only five teams performed daily goals across the whole 24 weeks. Program documents were analysed to identify barriers to adherence and retention of participants. A Body Shape Index (ABSI) was used to determine individual anthropometric change from baseline to 8, 16 and 24 weeks. To examine adherence to the daily challenge activity over 24 weeks the total amount of completed challenges adjusted for number of active teams was plotted by week. T-tests were used to compare completion rates of the challenges, challenge completion by day of week and between weekdays and weekends. Trial data on team activity, demographics and anthropometric outcome data were extracted to determine frequency of daily goal completion by teams throughout the competition and to describe participant characteristics. MethodsĪ qualitative component evaluation methodology was used. This paper evaluates the theoretical merit of and adherence to these goals. Our team weight loss competition trial for participants with a BMI ≥30 used cash prizes to incentivise completion of nine daily behaviour goals. Information is needed on what behavioural weight loss goals to recommend and how to attract and retain them in interventions. New Zealand Pacific and Māori populations measure disproportionately high on the international body mass index (BMI).
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