title: Intensive lifestyle intervention goals can be achieved as effectively with large groups as with small groups.
abstract: OBJECTIVE
  The purpose of this study was to assess if group size is associated with weight loss outcomes among participants in an adapted diabetes prevention program.
  
  
  METHODS
  Adults at high-risk (N=841) for CVD and diabetes were enrolled in the lifestyle intervention in 2011. Multiple logistic regression analyses were used to identify if group size (smaller group<16 participants; larger group ≥16 participants) was independently associated with weight loss outcomes among participants.
  
  
  RESULTS
  In the bivariate analyses, participants in the smaller groups compared to those in the larger groups were significantly more likely to have a higher baseline body mass index, to attend fewer intervention sessions, and less likely to self-monitor their fat intake for ≥14 weeks, and to have lost less weight during the core intervention (5.1 kg [SD 4.7] versus 5.8 kg [4.5]). However, analysis adjusting for age, sex, baseline BMI, achievement of the physical activity goal, number of weeks self-monitoring fat intake, and group size, found only two factors to be independently associated with achievement of the 7% weight loss goal: frequency of self-monitoring of fat intake and achievement of the physical activity goal.
  
  
  CONCLUSIONS
  Our findings indicate that intensive lifestyle intervention goals can be achieved as effectively with large or small groups.
authors.affiliation: Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Brokaw
authors.affiliation: Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Diane
authors.initials: D
authors.lastname: Arave
authors.affiliation: Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Derek N
authors.initials: DN
authors.lastname: Emerson
authors.affiliation: Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Marcene K
authors.initials: MK
authors.lastname: Butcher
authors.affiliation: Montana Department of Public Health and Human Services, Helena, MT, United States.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
authors.affiliation: Montana Department of Public Health and Human Services, Helena, MT, United States. Electronic address: tharwell@mt.gov.
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003695:Delivery of Health Care; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D018752:Diet, Fat-Restricted; D015444:Exercise; D005260:Female; D006126:Group Processes; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009009:Montana; D015999:Multivariate Analysis; D016017:Odds Ratio; D050177:Overweight / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012648:Self Care; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Cardiovascular disease related risk factors; Diabetes prevention; Group size; Intervention studies; Montana; Pre-diabetes; Type 2 diabetes mellitus; Weight loss