摘要：Background: According to Statistics Canada, the number of adults who are overweight or obese rises every year in Canada. As such, it is obvious that various public policies are not working. After extensive community consultation, the Healthy Weights Initiative (HWI) started in Moose Jaw and expanded to Regina, Saskatchewan, Canada. Objectives: This study aimed to determine adherence, factors affecting adherence and their impact on various health outcomes. Methods: From January 2014 to March 2015, 229 participants started the comprehensive 6-month HWI program. It was determined that having a “buddy” and signing a social support contract with three additional family members or friends were important to program adherence. As such, both policies went from being recommended to becoming mandatory. From April 2015 to August 2016, 771 additional participants started the program, allowing evaluation of the two new policies. Moreover, HWI participant adherence was compared to that of 100 new YMCA members. Results: Among the first 229 HWI participants, 79.9% completed the 6-month program. After the two new policy changes among the 771 participants, 96.1% completed the HWI program (risk ratio =1.20; 95% confidence interval [CI]: 1.01–1.49). In comparison, among the new YMCA regular members without supervision or assistance, 14.0% were still fully adhering to their fitness program after 6 months (RR =6.85; 95% CI: 3.88–12.10). After logistic regression, the only variable with an independent effect for not completing the HWI program was not having a spouse/partner supporting the program (odds ratio =2.31; 95% CI: 1.13–3.67). Although weight loss reductions were obtained (mean: 4.3 kg), the more significant benefits observed were health outcomes. For example, the prevalence of depressed mood reduced from 44% to 16.4% ( P =0.000). Conclusion: With two new policy changes, including a mandatory “buddy” and a signed social support contract, the HWI has become more successful at promoting program adherence. Moreover, numerous positive health outcomes have been obtained during this free, community-based initiative.
关键词：community-based; obesity; social support; program adherence
