What matters for weight loss in behavioral trials in the Latinx community: Learnings from three randomized controlled trials

Background: Nearly half of Latinx adults in the US are obese, making effective weight loss interventions crucial to prevent associated chronic conditions.Objective: To identify factors associated with increased session attendance and clinically significant weight loss among Latinx adults. Participants: Latinx participants from the Vivamos Activos (n = 207), Vida Sana (n = 191), and HOMBRE (n = 424 Latinx men) randomized clinical trials.Design: Post-hoc analysis of randomized controlled trial data. Intervention: Culturally-adapted behavioral weight loss interventions based on the Diabetes Prevention Program among Latinx adults over 12 months.Main outcome measure: Demographic, clinical, and psychosocial predictors of session attendance and 5% weight loss at 12-months. Statistical analysis performed: Bi-variable associations between baseline characteristics and outcomes were tested with chi-square and t-tests. Those with p-value< 0.15 were then included in stepwise logistic regressions.Results: Participants (N = 822) were middle age with diverse socioeconomic backgrounds. Older age in the Vivamos Activos and Vida Sana trials, and lower acculturation in the HOMBRE trial were significant predictors of increased session attendance. Factors associated with 5% weight loss varied by trials. These included younger age (OR 0.96 95% CI 0.92, 0.99) in Vivamos Activos, higher acculturation (OR 1.88 95% CI 1.05, 3.37) in Vida Sana, and higher education (OR 3.20 95% CI 1.3, 7.03) and greater body image dissatisfaction (OR 1.29, 95% CI 1.04, 1.6), and lower acculturation (0.69 95% CI 0.5, 0.96) in HOMBRE.Conclusions: Few and conflicting baseline characteristics were associated with session attendance and clinically significant weight loss, suggesting that alternative approaches to optimizing interventions are needed.