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Reflections of Learners in an Online Environment
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presented by

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REFLECTIONS OF LEARNERS IN AN ONLINE ENVIRONMENT: ATTEMPTING
TO APPLY LEARNED KNOWLEDGE AS PART OF A WEIGHT MANAGEMENT

PROGRAM

By

Melissa Tolan-Halleck

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF SCIENCE

Department of Agriculture and Natural Resources Education
and Communication Systems

2004

ABSTRACT
REFLECTIONS OF LEARNERS IN AN ONLINE ENVIRONMENT: ATTEMPTING
TO APPLY LEARNED KNOWLEDGE AS PART OF A WEIGHT MANAGEMENT

PROGRAM

By

Melissa Tolan-Halleck

Weight management after a weight loss continues to be a health challenge for
many individuals. The concept of internalizing or applying the knowledge that has been
learned is difficult. This is what is often referred to as weight management success or
living a healthy lifestyle. The online learning environment can offer new avenues for this
style of learning. This qualitative research study is grounded in three key areas; 1)
distance or online learning can compliment traditional behavioral interventions for weight
management success and the application of learned knowledge, 2) learning style can
effect the learning process in which weight management efforts take place and 3)
cognitive behavioral therapy is an appropriate intervention for weight management
success. These concepts are looked at after an in depth review of the literature and afier
interviewing participants in an online learning environment as part of a weight
management program. Concepts are clarified and recommendations are made regarding a
supplemental online learning environment to apply the knowledge learned for weight

management SUCCESS.

Cepyright by
MELISSA TOLAN-HALLECK
2004

TABLE OF CONTENTS
LIST OF TABLES

CHAPTER I, Introduction
The Context

Purpose
Definition of Terms

CHAPTER II, Review of Literature
Conceptual Framework
Assumptions

CHAPTER 111, Research Design and Methodology
Method
Sample Description
Research Design
Sample Selection
Data Analysis

CHAPTER IV, Results/ Themes
Learning Style
Degree of Focus
Convenience
Group Interactions
Role of Facilitator
Motivation to Continue Learning
Support
Experiences and Feelings Related to Technology
External vs. Internal Benefits
Online vs. Face-to-face Learning

CHAPTER V, Conclusion and Recommendations
Discussion
Limitations
Conclusions
Future Research Opportunities

APPENDICES
Appendix A: Recruitment letter
Appendix B: Interview Guide
Appendix C: Contact Summaries

REFERENCES

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LIST OF TABLES

Table 1: Coding Chart

Table 2: Summary of responses from all Interviewees when asked about
their Learning Style

Table 3: Summary of responses regarding focus on goals for weight
management success, awareness and Commitment to meeting these
goals

Table 4: Summary of responses regarding convenience of using
online forums for weight management support

Table 5: Summary of responses regarding interactions with other
learners or with the facilitator in a f2f or online group

Table 6: Summary of responses regarding the role of the facilitator

Table 7: Summary of responses regarding what keeps a learner
interested and motivated to continue Learning

Table 8: Summary of responses regarding support

Table 9: Summary of responses regarding experiences and feelings
related to the computer or the technology involved with
online forums such as the eweightmanager

Table 10: Summary of responses regarding experiences and feelings
of gained external vs. internal benefits from participating in
online forums

Table 11: Summary of responses regarding different experiences and
Feelings with face-to-face vs. online learning

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Chapter I
Introduction

The Context

Technology enhanced learning continues to grow rapidly, especially with the
many individuals who use the Internet. This growth is due in part to the popularity of
communication via the web, but also influenced by the learner's need for convenience and
flexibility. Many universities are turning toward distance education as a low-cost way to
offer traditional courses, generate excitement and appeal to a wider array of students,
ofien the non-traditional student. The non- traditional learner appears in many venues,
including the community education setting or group behavior therapy. The non-
traditional learner or sometimes referred to as the adult learner is often self-motivated,
which as will be described later, is a positive attribute for a distance learner. While the
use of the Internet for social communication is readily apparent, the degree to which the
Internet can facilitate learning is largely open to question (Warf, Vincent and Purcell,
1999). On-line distance education is often associated with problems of high attrition
rates, maybe related to the lack of face-to face time and too much focus on the
technology or the electronic connection which therefore can affect learner motivation and
encouragement (Garland, 1993).

Supporters of distance learning claim that collaborative learning and working in
learning communities can diminish some of the feelings of isolation that may lead to this
attrition (Eastmond, 1995). Learning communities are small groups that are formed

collaboratively. Furthermore, learning communities allow the learners to establish

mutual ties, which provides a support system, enhancing the learners commitment to
learning for both self and peers within the knowledge community (Palloff & Pratt, 1999).
This commitment for learning is an important aspect in the weight management
community. The problem of obesity in our country today is at a critical stage with an
estimated 25% of the United States population being obese (Kuezmarski, 1992). These
conditions substantially increase the risks of morbidity and mortality as well as social
stigmatization and discrimination. As a major cause of preventable death in the United
States, obesity poses a major public health challenge. For the purpose of this study, the
non-traditional adult learner will be an individual who is involved in a structured
behavioral weight management program. There are many treatment options for obesity.
However, behavioral therapy methods for weight management have shown the most
positive improvements in long-term obesity treatment outcomes. Extended treatment
shows that the longer the behavioral therapy program, the better the long-term weight-
loss outcome compared to standard treatment (Wadden, Foster, & Letiza 1994).
However, follow-up data suggests that after extended treatment ends, adherence
diminishes and individuals begin to regain their weight (Perri, 1998). Increasing social
support and incorporating problem solving techniques has demonstrated significantly
greater weight reduction and higher rates of treatment completion. (Wing, 1989).
Sbrocco, Nedegaard, Stone & Lewis (1999) make the proposition that outcomes and
goals concerning weight and food extend well beyond the external factors of caloric
intake. Self-esteem and social acceptance must be part of the long -term outcomes.
These claims can lead to the presumption that distance or online learning could enable

patients and counselors to have more therapy time, which could allow for an increase in

support and the feasibility of incorporating problem-based learning. The use of distance
learning could enable health professionals to extend patient to therapist contact at a
minimal fee and allow for more self-motivated interactions of the individuals in
treatment.
P_wno_ss

Because adults are involved in behavioral treatment to bring about some sort of
change, they are gaining new knowledge. Webster’s dictionary defines knowledge as,
having experiences. Adults have many experiences therefore their potential for learning
collaboratively, the sharing and negotiating of one anothers' knowledge, will be explored.
There is little evidence available to support the use of online learning as a compliment to
the traditional multi-disciplinary approach to weight management. However, with the
prevalence of obesity on the rise and long-term weight management outcomes continuing
to be poor, there is a need to improve current weight management treatment processes.
The focus of this research will be to better understand learners' experiences with an
online environment and how these experiences affect the learners application of learned
knowledge. This study will attempt to gain an understanding of individuals’ reflections of
an online learning environment as part of a weight management program.

The research is grounded in the areas of online learning, collaborative learning
and cognitive behavioral therapy for weight management success. These concepts will

be reviewed in great detail in chapter two.

Definition of Terms

F ace-to-face learning - Learning in the traditional style with an instructor and

learners in a classroom or same geographical location

Asynchronous learning— Learning that can occur at anytime and at irregular
intervals, meaning that individuals can communicate online without scheduled

interactions (Palloff & Pratt, 1999).

F orums- A public discussion of questions and sharing of common interests

(Allee, 1984).

Sense of Engagement- The connectedness and motivation a learner feels toward
their behavior change/ learning and the self-efficacy that this new lifestyle is

sustainable

Transformative Learning- Learners change their meaning schemes (specific
beliefs, attitudes, and emotional reactions) and to do this they must engage in
critical reflection on their experiences, which in turn leads to a perspective
transformation. This perspective transformation is the process of becoming
critically aware of how and why our assumptions have come to constrain the way
we perceive, understand, and feel about our world, by changing these structures of

habitual expectation to make possible a more inclusive, discriminating, and

integrating perspective. These meaning structures are frames of reference that are
based on the totality of individuals' cultural and contextual experiences that

influence how they behave and interpret events

Collaborative Learning- Learners negotiate from one knowledge group to
another. This occurs by joining a transition support group on the way to a final
goal. Joining the transition group is the process by which collaborative learning

occurs (Bruffee, 1999).

Knowledge Community- A group of people with similar interests and goals that
constitutes membership by a certain language (computers, literacy, mathematics,
church etc.). There is an interdependence between group members, for this is

how we define knowledge (Bruffee, 1999)

Acculturated— Full fledged, competent members of some community or

knowledge group (Bruffee, 1999).

Weight Management- Adherence to the lifestyle and practices that will enable an

individual to stay at a healthy weight.

Cognitive Behavioral T herapy- A treatment used for weight loss and
maintenance, based on the conceptualization of the process that maintains the

problem in question (Wadden & Stunkard, 2002).

Chapter II

Review of Literature

Conceptual Framework

The purpose of this chapter is to review research and literature that relates to
learning style of the adult or non-traditional learner, the components of an online learning
environment and cognitive behavioral therapy for weight management success.

The sample population to be studied and assumptions made are of the non
traditional and/or adult learner. The constructivist view will be the foundation upon how
this occurs. The following assumptions are made of constructivism by Guba and Lincoln
(1989) truth is a matter of consensus among informed constructors, not of
correspondence with objective realities, facts have no meaning except within some value
setting, hence there are no objective assessments of propositions. Phenomena can only be
understood from the context in which they are studied and generalizations are not made
from one situation to the next. The experiences that individuals have are what construct
their knowledge and the non-traditional learner typically has accomplished many life
experiences. Drawing on the insights of theorist and researchers, the study will be

grounded in the following concepts.

1) The components of online learning can compliment the non- traditional style of
learning as well as provide an environment for weight management support and the

application of learned knowledge.

Online Learning. Online learning is really still in its' infancy when looked at in
its' entirety. New programs and technologies are being developed every day to simulate
the most prominent features of a face-to- face classroom. A face-to—face classroom
allows for learners and teachers to be present in the same geographical location. What
kind of affect does the absence of the face-to- face contact have on an individual's
learning experience? Is this adversity outweighed by the many positive attributes of
online learning?

A large portion of distance or online learning research has focused primarily on a
comparison against the traditional style of learning. The basic research question has
often been asked, "Is distance education as good, or better than, traditional education?"
As noted by Saba (1998) this type of comparative study fails to adequately define
'traditional' or 'distance' education.

According to the constructivist learning theory teachers become guides rather than
dispensers of knowledge and more emphasis is put on the role of the student in
constructing knowledge. Thus, geographical distance becomes irrelevant, and technology
is only a factor in its' ability or inability to facilitate communication and help learners
construct knowledge (Saba, 1998).

A significant development in the growth of information technology has been the
use of computers for personal communication. Assuming all parties are connected to the
Internet, people can now communicate via email, bulletin boards or chat rooms. The
level of intimacy that can be present with computer communication is widely disputed as

well as the definition of intimacy. (Darlega & Margulis, 1983; Durham, 1988) discuss

intimacy as the amount of self-disclosure in a relationship. Many studies have shown
that when one person strategically releases more personal information the other person is
led to respond with equally increased levels of intimacy. The option to be anonymous
with online learning has shown to increase the level of sharing, in particular intimate,
personal information. In a study of student collaboration online, Oliver, Omari and
Herrington (1998) found that students who were acquainted displayed a strong level of
collaboration and cooperation. Van Gelder (1996) has argued that it is the absence of
seeing the other person that increases the degree of intimacy. She contends that the most
important thing about the person is not their sex, race or gender, but their mind. She has
experienced people having a higher degree of intimacy when using computer
communication versus 'real life'. This concept relates to the phenomenon that it is easier
to talk to a stranger in the form of a counselor then someone who was known previously.

As the research continues to unfold along with her personal experiences as an
educator it becomes more clear that for online learning to be optimal the learning and
instructional strategies that are known as the norm need to be redefined.

In order to support learning as a knowledge building process, learning
environments should allow for context, collaboration and practice to co-exist (Barab &
Duffy, 2000). The online learning environment can be an ideal place for this to occur.
Relevant discussions that occur online in a group setting and encourage problem solving
can be an ideal learning environment. As a learner’s sense of motivation is elevated the
potential for sustaining new behavior change increases.

Palloff and Pratt (1999), describe transformative learning as the unexpected result

of the online learning process, an internal motivation to continue learning. Intellectual

growth is expected when enrolling in a course, but personal growth is not necessarily the
reason students engage in the process of online learning. Mezirow (1990) states that
transformative learning occurs when learners encounter what he describes as a
disorienting dilemma - a dilemma that causes the learner to critically assess the nature
and the use of knowledge, belief systems related to power and social relationships. This
encounter can cause anxiety and inaction within the learner. Therefore, group support
becomes very important. By simply getting involved in an online class, a learner can
immediately encounter a disorienting dilemma. This is an environment in which
participants are expected to engage with the material, each other and the instructor in a
completely different way. Therefore the online classroom can be an ideal foundation for
transformative learning. Personal growth becomes a companion to intellectual growth as
the learner assumes more responsibility for the learning process and moves from student
to reflective practitioner.

According to social constructivists, learning is a social construct, which is
interposed by language via social exchanges (V ygotsky, 1978). The online community
can easily be established as a supportive environment that is inviting to collaboration,
social exchange and construct. The online environment is a community that allows for
open communication, social reinforcement, information exchange as well as the
opportunity to increase self-esteem and self-efficacy. The internal source of motivation
is then stimulated and may improve a learner's sense of satisfaction and achievement
(McIsaac & Gunawardena, 1996).

Computers, telephones and video conferencing can all be considered forms of

distance communication in that you are not meeting face-to- face. A study evaluating

the effectiveness of telephone counseling revealed that most telephone counseled clients
had not sought out previous counseling or information. It seems that clients are willing to
use and respond positively to counseling when the counselor is at a distance, not face to
face (lscoe, Hill, Harmond, & Coffman, 1979).

Despite the rapid growth of online learning programs, many challenges must be
faced. If the focus with educators is to transmit information they are likely to leave
learners feeling isolated and unmotivated, leading to procrastination and eventually
attrition (Garland, 1993). For effective learning, the material or the message must be
contextually relevant, problem based and perceived as valuable to the learner's present
situation (Meerriarn & Cafarella, 1999). Contextual learning is a process where the
learning is tightly bound to the environment and circumstances surrounding the learning.
Hansman (2001) describes when content is learned within contexts that are meaningful
and relevant to the learner, their motivation, interest and achievement improves
dramatically. Integrating content to real world experiences in an online environment can
be a challenge in itself. An online environment defined by structure and planned
communication may not allow for the spontaneity needed to respond to emerging
contextually relevant issues. Therefore allowing free discussion becomes very important,
but not at the expense of inadequate feedback and guidance to provide engaging topics
for discourse. Ethical issues of confidentiality, inadequate counselor intervention, over
zealous behavior of online learner's secondary to their anonymity and equality of Internet
access are more challenges for the use of on-line learning (Sampson, Kolodinsky &

Greeno, 1997).

10

The gap that is most evident in distance learning is that between technology and
learning. The gap diminishing relies on the instructor’s ability to modify the teaching to
fit the learner's needs for learning. For instance research has proven that for adult
learning to be meaningful it needs to be contextual and relevant. Through my work as a
adult counselor and educator I take the role as the facilitator, this role allows for the
learner's to feel empowered and for their life experiences to become a part of the learning
process. Hirshbuhl, Zachariah, & Bishop, (2002) note in their research that the widening
gap in distance learning between the learner and technology is happening for two
reasons; 1) Students and teachers are having difficulty shifting their teaching and learning
paradigms, and 2) The inability of students and teachers to deal with technology-related
problems. This gap widening also can be attributed to high attrition rates.

When this paradigm shift occurs with learners and teachers an optimal experience
can occur. A study was done by Hirshbuhl et a1. (2002) with a graduate class in
instructional design. The outcomes indicated that students need very clear, concrete
examples of what is expected and weekly assignments must be evaluated by the
instructor; there must be a high level of interaction and appropriate feedback. The
research survey showed that students collaborated more with each other and enjoyed the
collaboration in comparison to the traditional campus—based courses. Students reported
that they enjoyed the increased communication of the online course. Data also displayed
students spending more time working on the course; this was partially due to the out of

class meetings as well as the variable times that students post messages through out the

day (Hirshbuhl et al., 2002).

ll

2) Learning style can affect the learning process in which weight management
efforts take place. Therefore, collaborate and transformative learning will be explored.
According to Webster's Dictionary, collaborative is to labor together to act jointly and
transformation is to change of outward by an inner nature (Allee, 1984). Therefore
collaborative and transformative learning can be viewed as occurring jointly or together
and coming from the inner to bring about change to the outer. This type of learning
would be most feasible in a group and could have a significant effect on an individual's
personal knowledge and growth. In turn, personal growth could have a significant affect

on self-efficacy and self-worth.

Collaborative learning. The conceptual framework will build support for the
claims of online collaborative learning as a means for enhancing an individual’s personal
knowledge and growth. The theory that a learner's self- identity is pivotal in the ability to
integrate into the learning environment/ community will be explored (Mezirow, 1991;
Tinto, Goodsell-Love, & Russo, 1994). In other words, social functioning is a key to the
learning process. Collaborative learning is once again defined by Bruffee's (1999) theory
of learning as representation of renegotiating fi'om one knowledge group to another,
which occurs by joining a transition support group on the way to a final goal. One
learner describes an experience with collaborative learning as each of us began to change
and we were learning, not from the books we were reading but the influences and
discussions that occurred in the group (Bruffee, 1999).

This style of learning has a strong social response: it is through this negotiating

with others that learning occurs. The gaining of membership into a learning community

or group of individuals with a specific level or type of knowledge happens by joining a
transition or support group on the way toward the final goal. Group work or discourse
between individuals whether online or face-to-face becomes very important for the
building of knowledge to occur between individuals.

Group work with collaborative work is more then cooperatively working together,
it is the gaining of knowledge with and through others, it places much emphasis on the
process rather then the end product. There are five phases for collaborative learning that
Yeok-Hwa (1998) refers to as: engagement, exploration, transformation, presentation and
reflection.

The engagement phase is important for learners to take ownership. The facilitator
sets the stage by providing a collaborative activity. The exploration phase allows
learner's to take stock in what they already know, what they hope to learn and how they
will share what they have learned with others. The third phase deals with transformation
of knowledge. This is where learners engage in activities as a group to reshape the
information by organizing, clarifying and elaborating. It is critical at this stage of the
learning for all group members to contribute. It is easy to allow the most assertive voice
to take over, which can inhibit other group members fiom learning. Online group
discussions may help prevent this by allowing all voices to be heard. Asynchronous
interactions are those that do not take place in real time, this type of interaction allows
learners to pace themselves and reflect before contributing to the discussion. This
additional process time can prove beneficial for many learners. Presenting the
knowledge is the next phase. The audience receiving the presentation should be authentic

which allows for appropriate feedback and responsiveness. This can be done with a peer

l3

group or a professional group with a genuine interest in the findings of the presentation.
Sharing information gained with peers is an effective motivational strategy for learners,
this sharing can occur asynchronously online or face-to-face. The last phase is most
important for the individual gain of knowledge. Students reflect upon what they have
learned while identifying strengths and weaknesses in the learning process both
individually and collaboratively. As stated earlier, an online -asychronous environment
can be an ideal space for reflection and discussion.

There is much research to support this description of the collaborative learning
process. Merriam & Caffarella (1999) state that to be effective, adult learning must be
contextually relevant, problem based and applicable to the learner's current or desired
lifestyle. Stated similarly by Dewey (193 8), education is not to learn merely to acquire
information but rather to bring that learning to bear upon our everyday actions and
behaviors. Consistent with this goal, collaborative learning can prepare learners to be
critical thinkers and acquire the skills that are necessary to be effective participants in
their personal and professional communities (Yeok-Hwa, 1998). A main feature of
collaborative learning is discussion and it is through this discussion that learning occurs
(Golub, 1988). These ideas supplement some of the objectives for successful weight
management interventions, as will be discussed in more detail when cognitive behavioral
therapy for weight management intervention is reviewed.

By allowing discussion and sharing to occur learners can begin to bring relevance
to their learning. As Dewey (1 93 8) points out, the philosophy of education is not merely
to acquire information but rather to bear upon everyday actions and behaviors. The

learning process becomes inseparable from the environment in which learning occurs.

14

Hansman (2001) agrees with this philosophy by fiuther stating that when content is
learned with a meaningful and relevant context the learners are more motivated,
interested and achievement driven.

A recent study by Twigg (1994) reiterates this concept by defining most students
as concrete- active learners, that is, they learn best from concrete experiences that engage
their senses. Many teachers are attempting to improve their practice and the learning
outcomes for students by incorporating active learning techniques such as working
collaboratively on projects and participating in small group discussions.

Christiansen and Dirckinck-Holmfeld (1995) have speculated that the
collaborative effort among learners can help them to achieve a deeper level of gained
knowledge. For this style of learning to occur the environment should include a) a group
of students with a shared goal for their learning process b) sharing of personally

motivating problems and interests and c) dialogue as the fundamental way of learning.

Transformative learning. The ideas presented this far relate to the concepts of
transformative learning, a phrase coined by Mezirow (1990, 1991) which refers to
learning as reflection and the interpretation of experiences, ideas and assumptions gained
through prior learning, a meaning making process which is rooted in the constructivist's
theory. The theory of adults learning through transformation and their own individual
experiences will be explored further (Mezirow, 1991; Tinto, Goodsell-Love, & Russo,
1994). Transforrnative learning is embedded in the way we communicate as human
beings and is a common learning experience not necessarily associated with personal

transformations. For transformative learning to occur learners need to become critical

15

and aware of their own as well as others' assumptions. Educators should take the role as
the facilitator and assist learners in participating effectively in discourse. Discourse is
necessary to validate the understanding of what and how one learns or to arrive at some
contentment regarding a belief. Best described in this context, learning is a social
process, and discourse becomes foremost to make meaning.

For learning to become meaningful, which then can enhance motivation and
adherence to the process, it must be incorporated by the learner into an active process
involving thought, feelings and disposition. This self—direction is best created in an
environment in which learners become increasingly adept at learning fiom one another
and problem solving in a group. Transformative learning is in essence the core of adult
education. It becomes clear that an important goal of adult education is to help the
individual learner become an autonomous thinker or an active learner, by learning to
negotiate his or her own values, meanings and purposes rather then to uncritically take on
those of others. Self-reflection or "turning back" also becomes important in this process.
Becoming critically reflective of assumptions involves critiquing a premise of which the
learner has. As described by Mezirow (1997) a dialog program brings learners together
in a protected environment without an agenda, leader or task to be completed. A
facilitator initially can help the group think collectively and share assumptions. Topics
will emerge as participants begin to understand how others think and feel about common
issues and one another. Learners begin to understand how their lifestyle, thoughts and
expectations mold their experiences. (Mezirow, 1997) Through this review of literature
the environment and style for which learning occurs can prove to be of vital importance

to the learning process.

16

3) Cognitive behavioral therapy is an appropriate intervention for weight
management success. Although behavioral therapy interventions prove to produce a
greater weight loss then alternative treatments, there is a lack of research to demonstrate
the long-term maintenance of the weight loss (Wilson & Franks, 1982). Obarzanek
(2003) nutritionist for the National Health Lung and Blood institute and project officer
for the Weight Loss Maintenance study states, “ The Surgeon General, the Secretary of
Health and Human Services, the medical community—everyone recommends that

Americans maintain a healthy weight.”

Cognitive behavior therapy for weight management success. Cognitive-
behavioral therapy (CBT) is based on the cognitive conceptualization of the processes
that maintains the problem in question. The focus on process allows for cognitive
restructuring and for the individual learner to identify and change the target maintaining
mechanisms. This process allows individuals to attempt new ways of behaving, test their
expectations regarding the behavior change and evaluate through self- reflection.
Cognitive behavioral therapy encourages learners to understand through experience how
things could be different and why they would desire change in the first place (Wadden &
Stunkard, 2002).

The following key strategies describe current behavioral treatment programs.
Most programs use a team approach with behavior therapists, exercise physiologists and
dietitians who lead groups and rotate based on the topic content. Self-monitoring, which

includes writing down all calories consumed and activity expended on a daily basis, is

17

emphasized strongly with behavioral therapy interventions and is often thought of as a
predictor of long term success (Wadden & Stunkard, 2002).

However, after reviewing the concepts of CBT and noting the continued poor
outcomes for weight management success, as Perri et a1. (1984) acknowledges, "The
maintenance of treatment effects represents the single greatest challenge in the long-term
management of obesity"- I can't help but think there must be more to it.

Monitoring only external factors doesn't encourage self-reflection and critical
thinking to occur. Goal setting is a critical component in a CBT weight management
program. Goals are both externally monitored as well as behaviorally focused. Short-
term goals that are reasonable are emphasized. Nutritional aspects of weight loss are
taught through lifestyle modifications and are often demonstrated in class. A key lesson,
beyond the nutritional content in the food itself is how to accomplish this new style of
eating or applying the knowledge learned. With exercise proving to be the single best
predictor of long— term weight maintenance success, behaviorally based programs
encourage an active lifestyle and learning the specific skills required to become more
active. Stimulus control remains the hallmark of behavioral treatment programs,
assuming that the environment controls the behaviors. However with more self-
awareness and emphasis on the cognitive aspects of weight management the shift is
focusing on individuals' thoughts and assumptions in order to defeat inappropriate eating
behaviors. Problem solving allows individual learners to generate solutions, try it and
then evaluate the effectiveness.

Cognitive restructuring is important but is often an abstract area for individuals to

place emphasis. The dieting industry breeds many negative thoughts into the minds of

18

dieters. Therefore, for weight management to be successful these often irrational,
negative thoughts need to be recognized and then countered with more positive self-
empowering statements. Relapse prevention consists of recognizing a slip up as a normal
part of the weight loss process. Situations are anticipated and plans are developed to
cope appropriately, the idea is to prevent a lapse from becoming a relapse (Wing, 1989).
Wadden and Stunkard (2002) suggest that the disappointing long term results of
behavioral weight maintenance may be attributed to two factors. The first is the neglect
of considering cognitive factors as contributing to weight regain. The second is the
ambiguity over treatment; weight loss vs. weight maintenance. This failure to stay
engaged can be related to a progressive decrease in a patient’s belief that they can reach a
worthwhile weight goal. This is in response to the common decline in weight loss after
4-6 months of attempting to lose weight, and the realization that they will most likely not
meet the unachievable weight loss goals or the other objectives they had hoped to achieve
with their weight loss. This thought process often leads to decreased feelings of self-
efficacy and confidence in their weight loss efforts. As a result, they abandon the strive
for further weight loss. This then leads to undervaluing the weight loss they have
achieved and a minimizing of any other gains they have made. In response to their
analysis of weight regain, Wadden and Strukard (2002) recommend that weight
maintenance include assisting patients to acquire, and then practice the behavioral skills
and cognitive responses needed for effective weight control. This study will investigate
this practicing and responding recommendation with the addition of online discussion

forums, a form of supplemental support.

19

Through a series of experiments designed to isolate different weight maintenance
approaches Perri et a1. (1984) found that a combination of four strategies was most
effective for maintaining weight loss: 1) continued professional guidance after weight -
loss treatment 2) skills training to help individuals cope with high risk situations 3)
structured physical activity, and 4) social support from friends or family.

Another study by Mustajoki & Pekkarinen (1999) concluded that weight regain is
not distinctly relative to consistent patient to therapist contacts after treatment. Rather, it
is recognized that the ability of subjects to take responsibility for their lives might be a
better predictor for successful maintenance than continuos therapeutic contact or the
prescribing of exercise and diets.

Perri, et al. (1984) evaluated the effectiveness of a multi-component program
designed to enhance the maintenance of weight loss. This multifaceted program of post
treatment strategies followed the recommendations of Stuart (1980). Weight
maintenance programs should include the following: continued self-monitoring of
positive behaviors, fiequent post-treatment client to therapist contacts, and active client
participation in self-help groups. The multi-component program vs. therapist booster
sessions demonstrated positive effectiveness. The major observation of this study is that
a program of post treatment social support and client-therapist contacts significantly
enhanced the maintenance of weight loss. The findings of this study support the current
obesity treatment literature in recommending longer initial interventions followed by a
maintenance program offering continued therapist/ participant contacts. Novartis, the
maker's of 0ptifast® a liquid formula used for very low medically monitored calorie

levels, encourages a behavioral component of therapy as well as ongoing contact with

20

participants. Ninety five percent of former program participants needing staff support,
peer support and self- monitoring are not engaged. These individuals are at high risk for
weight regain ("Regional Meetings, " 2000).

As discovered in the review of literature related to online learning, collaborative
and transformative learning as well as cognitive behavioral therapy new methods may

exist for engaging individuals in their long-term weight management success.

21

Chapter 111

Research Design and Methodology
Method

Research Question
1) What are the reflections of learners in a supplemental online environment in regards

to applying the knowledge learned as part of a Weight Management Program

Firestone (1987) states that, "qualitative research is rooted in a phenomenological
paradigm which holds that reality is socially constructed through individual or collective
definitions of the situation."

This study was conducted using qualitative research methods. The individual or
collective definitions of the situation that Firestone discuss are the basis for this
qualitative research study which concerns an understanding of the phenomenon, gaining
support and increasing self-efficacy for adult learners in an online environment as part of
a weight management program.

The qualitative research design includes using criterion sampling to identify particular
self- motivated learners. All individuals who met the criteria will be mailed a letter of
invitation to participate in the study. Participants who volunteered to participate were
called and an interview was set up. The six interviews were held over a two-week span.
The interviews were held in an area that was comfortable and convenient to the
interviewee. Interviews were audio- taped and an interview guide with open -ended
questions was used. Each interview was about 30-90 minutes in length. The audio-taped
interviews were transcribed the following week. The transcriptions were read through as

soon as possible, to allow the researcher a sense of freshness since the actual interviews

22

(within two weeks from the last interview). After the initial read through of the
transcriptions, themes began to emerge. A table of codes was developed to explain the
data and how it was emerging. This table was also used to gain inter-rater reliability.
The code table and the transcriptions were provided to an unbiased researcher and was
checked for reliability of emerging themes. Contact summaries and narrative displays
were developed to continue compiling, organizing and minimizing the data collected.
The organizing and analyzing of the data was done over 2 weeks. The last phase of
analysis was to do member checking. Each interviewee received a copy of their contact
summary and they were asked to reply with a confirming or dis-confirming response.
This allows for increased validity of the data that is collected.

Interviews help the researcher understand the experiences of learners in an online
environment who are attempting to maintain healthy behavior change. Respondent
feedback helps the researcher to make assumptions and recommendations for an effective
online environment to supplement the learning and interactions of individuals who are
participating in a weight management program.

The constructivist theory and the ideas of Firestone are similar in that knowledge
is built through experience. The researcher's epistemological views run parallel to this
concept, therefore, it makes most sense that the data for this project was collected and
analyzed using qualitative methods. The research question is asking to gain knowledge
through learners’ reflections while they are participating in an online discussion board
and attempting to apply knowledge learned.

The topic of weight management success is baffling the psychology and the

medical arenas with poor outcomes in the research. This research study is beneficial to

23

gain a thorough understanding from the voices of individuals who are amidst this battle
(Wadden & Stunkard, 2002). Qualitative interviewing within a formative style of
research with a specific population allows for some disclosure of this puzzling epidemic.
The target population is individuals who are attempting weight management success
while participating in a structured program, which includes the use of online discussion

forums for ongoing support.

Sample description

The sample in this study was drawn from a hospital based weight management
program. All potential respondents have completed an intensive weight loss program
(followed by a team consisting of dietitians, behaviorists, exercise professionals and
physicians, weekly group meetings, medical monitoring and as needed individual
consultations). The respondents are automatically eligible for this maintenance phase of
the program if they completed the sessions for the first phase, which is equivalent to a 16-
26 week program. The characteristics of the sample create a diverse population from
various economic, academic and socio-cultural statuses. The population that will be
sought are those who are in the maintenance phase but have also decided to participate in
the online discussion board entitled the eweightmanager. The eweightrnanager is an
asynchronous discussion board that is facilitated and administered by the weight
management center's professional staff. Forums are posted and discussions can occur
simultaneously. The total population size is currently sixty-four participants and the
number continues to rise with more participants signing up daily. Sample individuals

were chosen based on criterion sampling. The sample size is limited to allow for in-depth

24

interviews that can provide rich data, while also taking into consideration the researcher's
time constraints. The choice of sampling approaches may be the single best implication
of the differences between qualitative and quantitative research methods. Purposeful
sampling is the selecting of inforrnation-rich cases for studying in depth, which will
illuminate the questions under study. Insight, understanding and credibility are sought
rather then empirical generalizations (Patton, 1987).

The researcher, along with her committee chair at Michigan State University are
the primary researchers in this project and she is aware and comfortable with her biases.
The interest in this subject matter arises from her experiences as a program coordinator
and nutrition therapist in a weight management program; the same program that the
sample population for this project was drawn. She has witnessed the many efforts that
individuals make to be successful with their weight management, and has also observed
the regaining of weight. Not only is weight regain detrimental to a person's self—esteem
but their confidence that they can be successful with weight management is damaged as
well. The emotional state during weight loss is very different then that during weight
management. This effect of weight loss needs to be taken into consideration when
attempting to help individuals become successful at managing their weight. Through
facilitating behavioral / nutritional therapy groups as well as her graduate studies in the
adult learning arena, the researcher feels comfortable with her assumptions and biases

regarding the adult learner.

25

Research Design

The design for collecting this data will be iterative and flexible. The phenomenon
being studied will evolve more through each interview and each experience that is shared.
In the early stages of interviewing more emphasis will be placed on the gathering of
themes and ideas. The interviews will include open-ended questions and will actively
solicit a wide variety of ideas and themes related to their learning experiences as a weight
manager, in particular with the eweightmanager discussion group. Through this process
of iterative research the topic begins to narrow based on interviewee feedback, concerns
in the professional field and the researcher's personal interest and focus.
This research project will use interviewing to collect data, as Patton (1987) indicates, the
purpose of interviewing is to allow individuals to enter other people's perspectives. The
interviewer assumes the task of making it possible for the interviewee to bring the
interviewer into his / her world. Thus, high quality, rich data may be obtained by talking
to informed people. The three suggested approaches to collecting qualitative data
through open-ended interviews include, 1) the informal conversational interview; 2) the
general interview guide and; 3) the standardized open-ended interview (Patton, 1987). A
general interview guide was used for this study. The guide is a list of questions or issues
to be explored during an interview. The guide is prepared before the interview to assure
similar information is obtained from different interviewees and that the basic elements of
the questions are covered. The advantages of an interview guide are that it makes the
interview more systematic and focused and allows the individual's perspectives and
experiences to emerge in response to the open-ended questions that are generally asked

during the interview. Qualitative interviews require the interviewer to frame questions on

26

the spur of the moment and yet obtain responses with deep meaning, description and
explanation (Rubin & Rubin, 1995)

The interview guide protocol was used as a method of collecting data for this
research because it allowed for some focus on concepts but yet the ability for participants
to express themselves fully rather then respond to a predetermined list of options. The
sequence of questions was not predetermined and questions were asked as additional
leads emerged. The data will hopefully uncover thoughts, feelings and experiences of
learners as it relates to their maintenance of weight and their experiences with the
supplemental online environment. This gained knowledge will allow the researcher to
develop a set of recommendations to assist behavioral health professionals in developing
better learner centered online options for weight management programs.

The secondary researcher will be the only person conducting the individual
interviews. A primary advantage of the personal interview is the high response rate, once
the respondents have agreed to participate, and the ability of the interviewer to note
specific reactions and eliminate misunderstandings about the questions being asked

(Rubin et al., 1995).

Sample Selection

Criterion sampling will be used to help with the homogeneity of the sample and
for specific criteria to be met. The purpose of homogeneity is to describe some
particular sub group in depth. The individuals chosen were chosen due to their
commitment level, which is evident by meeting the criteria selected. Since this project

hoped to uncover tactics for helping to keep learners engaged for long term weight

27

management success with behavior change, it is important that they experience some
success and reap some benefits of this behavior change in order to be motivated for the
second phase which is maintenance. The criteria that each respondent met includes 1)
logging onto the eweightmanager site at least three times, 2) at least one online response
to a faculty generated forum, 3) a weight loss of at least 10% of their initial weight and
4) at least one consult with a health professional during the weight loss phase. Twenty-
five individuals out of sixty-four met the chosen criteria. The twenty-five individuals
were mailed a recruitment letter, an invitation to participate in the interview process (see
Appendix A).

Six individuals responded to the recruitment letter. They were scheduled an
interview time. Each interview took place in a quiet and convenient location and was
tape-recorded for accuracy of the data collected.

Unstructured questions were designed to give the respondent the widest possible
latitude in their response. The interview guide as reported by Neumann (1994) is
essentially an outline of the specific areas of interest to be covered during the interview.
In this research, an interview guide was used (see Appendix B) that includes general
questions and more specific questions- all focusing on the respondents life experiences,
engagement with learning, weight management and in particular their experiences with
Sparrow Weight Management Center's eweightmanager, an online environment. The
interview guide helped make the interviewing more systematic and comprehensive for
each respondent.

A brief description of each interviewee allows the reader a visually contextual

perspective of each of the learners' reflections and experiences with online learning.

28

81 is a woman in her late forties who works in a management! team position with
the State of Michigan. She doesn't have a computer and email at home but uses
computers fluently and often in her career. She has no children and lives with her partner.
She lives in the Lansing area.

A2 is a woman in her late thirties who is employed as a communications director
and is well known in the community. She has teenage children at home and has a busy
social life. She uses the Internet fluently at home and with work. She lives in the
Lansing area.

G3 is a woman in her mid forties who has grown children and grandchildren in
the area as well as a school age child at home. She works part time for Michigan State
University. She uses the Internet fluently both at work and at home.

M4 is a woman in her late fifties who is retired from the State of Michigan. She
lives with her husband in the country. She is very comfortable with typing and
computers, however, she is just becoming familiar with discussion forums and email (the
Internet).

N5 is a woman in her early thirties who is the mother of two young children and
is employed full time with the State of Michigan. Her husband also works full time. She
enjoys the Internet, both at home (after the kids are in bed) and at work ( during breaks).
She is very comfortable with discussion forums and chat rooms.

S6 is a retired woman in her early sixties who has chosen a new after retirement
career in the travel business. She lives at home with her husband and travels often with
friends and co-workers. She is comfortable with the computer for work purposes,

especially email.

29

Data Analysis

Each interview was 30-90 minutes, we met in comfortable and convenient
locations for the interviewee. Several of the interviews were held at local restaurants,
others were held in private conference rooms, interviews did not all occur on the same
day, they occurred over a two week period of time. Field notes were taken and they
were audio recorded for increased accuracy. The audio-tapes and field notes were
transcribed for data analysis. A table of codes was developed after the initial read
through (See Table 1). The codes were developed based on the themes and concepts that
were beginning to emerge from the data. The table of codes included a definition for
each code and when it should be used. When coding the transcriptions the emerging
themes and concepts were used to minimize the data. The initial coding was shared
between researchers to ensure inter-rater reliability. This encouraged reliability and truth
in the themes that were emerging. Changes or additions to the coding schemes occurred
after this cross- checking occurred.

Contact summaries were developed for each interviewee to help summarize and
continue to minimize the data collected (see Appendix C). The summaries were also
used for validation through member checking, where each interviewee obtained a
summary of their interview content and was asked for approval in accuracy. Through out
this process of organizing and analyzing the data, codes were developed and themes
began to emerge. Identifiers that could be traced back to the respondent were effaced by
assigning anonymous names which were used for categorizing and gathering the data. A

contact summary form was completed after each interview, which includes data such as

30

contact type, interviewee, date, main themes that have emerged, follow up concerns if
applicable and a summary of the data collected. After all the interviews were complete
narrative displays were developed to help organize and compile the data; each emerging
theme was displayed along with the related response from each interviewee (See tables 2-
11).

The final phase of analysis was to confirm and disconfirm patterns among the
individuals. For increased validity member checks were done. This is a process where
feedback about the data and conclusions being made are solicited from the interviewees/
respondents. This is an effective way of ruling out the possibility of misinterpretation of
the meanings and perspectives of what is being said (Guba & Lincoln, 1989). This
process occurred by sending each interviewee their contact summary and then following
up by a phone call or email to obtain approval of accuracy in the data collected. This
process helps clarify concepts and assumptions by providing this information to
interviewees prior to making conclusions.

This chapter presented the qualitative method of data collection as well as rational
that was used for the design described; formative evaluation using personal focus

interviews. The next chapter will present the results of this study.

31

Chapter IV

Results

The purpose of this chapter is to present the results of the interviews that
were held with individuals participating in a supplemental online learning environment as
part of a weight management program. It is important to remember that the information
that was gathered was being told to a dietitian, counselor and facilitator for the online
learning environment and face-to- face classes at the weight management center. Each
interviewee had some prior interaction with the interviewer prior to this research.
Therefore, there was some degree of ease at each interview.

Interviews lasted anywhere from 30-60 minutes. An interview guide was used to
collect in depth subjective data on fairly specific topics and experiences, in this case
individual's experiences in an online learning environment. After the first read through a
table of codes was developed as themes emerged from the data. The codes were used to
help organize and minimize the data (See Table 1).

Table l. Coding Chart for learners experiences on the eweightmanager

 

 

Theme Tag Definition Description Example
Learning LS How learner best When the I like to learn from a
style learns or enjoys interviewee book and through

to learn describes how they discussion

learn best or how

they enjoy to learn

 

 

Focus F OC Aware of goals When an Being able to set a

and committed to interviewee goal and then check

 

 

 

 

 

32

 

 

meeting them

discusses what they
are doing or what is
helping them to meet
their goals or stay

focused in relation to

it off and feel the
satisfaction that
comes with making

it over the first step

 

 

 

their weight
management.
Convenience CON Easier to do, When an You can do it from
doesn't take too interviewee home, the
much extra time describes it as easier, convenience thing is
and effort less time consuming definitely there. My
or readily available schedule is so busy
and I like the idea of
not having to drive
out of my way to get
to a f2f class.
Interaction INT Participation in a When an It is comfortable to
with group either f2f interviewee get feedback from
facilitator or online describes an others. At first some
and/or other interaction with reservation due to
learners another group lack of f2f time with

 

 

 

member or the

facilitator

 

inline learning.

 

33

 

 

 

 

 

 

F acilitator's F AC What is the role When the It is important that
role of the facilitator interviewee they respond, but not
in an online describes the necessarily to every
group/ discussion facilitators role how message, other
they see it learners may
respond
Motivation to MOT What keeps When an It has to be
continue someone interviewee interesting to me and
learning interested to describes what keeps I have to enjoy it.
continue learning them interested in a
subject matter
Support SUP safe, not all alone When the It is comforting to
and being heard interviewee know that there are
and understood describes not feeling people out there in
alone, having a the same position
buddy, feeling safe that I am in.
or feeling
comfortable with
each others similar
situations
Technology TEC Experiences/ When an I’m from a different
program- feelings toward interviewee generation, I was a
ming computers; describes bit apprehensive at

 

 

 

 

 

34

 

 

 

 

 

including experiences that first. I just couldn’t
challenges with involve the actual manage it, couldn’t
figuring out the program or figure out how to use
program/ technological V it.
computer or situations
making
recommendations
for improving the
program based on
experiences
Internal vs. IE Internal benefit is When the It helps me to just
External intuitive and an interviewee talk through a
benefit of external benefit is describes the benefit situation. I don’t
EWM more measurable of the EWM as expect to learn or
intuitive/ emotional pick up new facts.
or as a source of new
gained physical
knowledge.
F ace-to-face F V0 The benefits and/ When the Sometimes it is more
learning vs. or challenges of interviewee difficult to speak in
Online learning online describes front of a group due
learning vs. face-to-face experiences/ beliefs to the fears of being

 

 

with learning

 

 

focused on and

 

35

 

 

 

directly identified as looked at then it is to
face-to-face learning sit at a computer and

or online learning type a response.

 

 

 

 

 

The following narrative displays (see tables 2-10) are summaries made after
reading and analyzing each interview transcription. They reflect the emerging themes

that became obvious after coding, minimizing and compiling the data.

Learning Style. How individuals like to learn is an important aspect when
listening to their experiences with an online learning environment.
Table 2. Summary of responses from all interviewees when asked about their

learning style.

 

 

Interviewee Interview

 

S1 Enjoys learning through reading and through discussion. As an adult she
likes to learn more through discussion, due to work, practical experiences

and need for relevance. Benefit of discussion, can talk and get it out.

 

A2 Prefer reading to lecture in order to absorb the information. Enjoy talking
in a group however easily distracted. Very comfortable talking in a group,

however, group size would sometimes not allow for this

 

G3 Learn visually, discussions are helpful to hear others ideas and insight.
Learn by making mistakes and discussing it. Enjoy speaking in a group;

sometimes she would stop talking due to feeling self conscious of

 

 

 

 

36

 

monopolizing the group.

 

M4

Need constant verbal discussion rather then reading otherwise she has
difficulty retaining information. Listening to others she considers

learning.

 

N5

She enjoys learning hands-on and by demonstration. She also enjoys
reading, taking notes and then asking questions. Interpretation occurs
through discussion and asking questions. She feels comfortable asking
questions in a group, however she feels that others can monopolize the

group discussion.

 

S6

 

 

She enjoys reading, investigating on her own and then discussing it with
professionals. She tends to try and take facilitators role, due to her
professional experience in this area, but she doesn’t want to be the one

with her hand up all the time.

 

A theme that continues to emerge is the necessity for discourse when learning. All

respondents mentioned the importance of discussion when learning. They explained the

benefits of discussion from the standpoint of getting it out to hearing others ideas and

insights to being a verbal reminder for better retention of information. When N1 was

asked how she most likes to learn, she responded:

Anytime there is something new that I'm trying, I usually read up on it, take notes

and then ask lots of questions. The ability to ask questions is the kicker, because

 

when you read you often don't always interpret it correctly. Having your

questions answered and talking is most important.

37

Learning in a group often allows for discourse. However, the group dynamics
also play an important role in the potential for learning to occur. When G3 was asked if
she was a person who felt she was able to speak up in a face-to- face class, she
responded:

I did speak up a lot, and there were some nights when I felt I should stop speaking

up just because I felt like I was the only one talking and you know, I didn't want

to be the only one talking.

The mention of monopolizing the group occurred in the context of three out of six
interviews. All though they each considered themselves to be social or group learners,
there was the concern that they or someone else was taking too much of the class time by

monopolizing the discussion.

Degree of Focus. How and what individuals do to keep aware and committed to
meeting their goals for weight management success. This was asked in the context of the
interview guide and their experiences with the online learning environment.

Table 3. Summary of responses regarding focus on goals for weight management

success, awareness and commitment to meeting these goals.

 

Interviewee Interview

 

Sl Eweightmanager participation helps her to maintain focus or get support
when needed. Availability and convenience allow the sense of feeling
connected to her weight management goals. Allows day-to-day
accountability and goal setting, which increases the likelihood of

accomplishing goals which helps with not disappointing self. Looking at

 

 

 

 

38

 

the whole picture is helpful for overall goals.

 

Being online and discussing is something that she enjoys and is
comfortable with, therefore would help stay engaged in the positive

changes that are being made in life.

 

G3

When gaining the internal benefit of support it is helpful to stay focused
on wanting to take care of external self-care. Eweightmanager has kept
me on target as far as what I’ve learned thus far, made me aware due to
convenience of always being there even to just read others' comments, it
keeps me drinking about it. Just knowing that it is available has kept me

thinking about my goals when traveling, etc.

 

M4

Talking about weight management allows her to her thoughts out and not
hold them in; it also allows time to reflect on self. Has a positive effect on
her whole day, knowing that she has accomplished some positive self-

care. Seeing, touching and being heard are important.

 

 

N5

 

Eweightmanager helps to stay more active toward her weight management
goals; it allows another avenue for support. The discussions online help
her to stay grounded; it is so easy to get off track and back into the dieting
mentality. Eweightmanager helps her to stay interested in her goals and
brings her into reality of what the next step is. When online she feels like
she's taking control for herself, giving herself the time and break that is
needed. It’s "me" time, allows her to run a mental checklist and do
something constructive toward maintaining her weight, active learning vs.

passive learning. Participation with eweightmanager reminds her to take

 

39

 

 

the conscious moment to refresh what she has learned in the face-to- face

classes. Reinforces the learning process.

 

S6 [no comments on focus]

 

 

 

 

Four out of six respondents described the eweightmanager as a tool that has
helped them to keep focused or engaged in their weight management efforts. 81 was
probed about the sense of feeling connected that she described by participating on the
eweightmanager:

Ahh, what do I mean by staying connected, umrn, that I have it available, you

know, available and in front of me, I guess that is where I'm staying connected.

Staying focused, focused as in the way I want to be with my weight management.

I know I can't say well, this week this is what I'm going to eat- this on Tuesday,

this on Wednesday etc. But I can say this is what I'm going to do today. I can

stay focused for that day.

N5 responds, " I run my mental checklist and make sure I am doing things, if not,
what can I do to change it."

When asked how participation in the eweightmanager has helped, G3 responds,
"I always know it's there. . .whether we are traveling or we are going to an event or
something, you know it's nothing I'm thinking about all the time, but I am always aware."

Two respondents mention the concept of self-care. M4 explains how the
eweightrnanger has been viewed as, " a time to reflect... and get some thoughts off my

mind".

40

N5 describes her feelings, " I feel like I'm kind of taking control... and making

sure things happen rather then letting things happen to me".

Convenience. Comments on the convenience of using an online environment

such as the eweightmanager, for weight management support.

Table 4. Summary of responses regarding conveniences of using online forums for

weight management support

 

Interviewee

Interview

 

Sl

Can communicate with people one way or another at anytime without
making the drive to the face-to- face classes. Location of face-to- face
classes is inconvenient with my work and home location. Always

available for support or resources.

 

A2

Schedule is busy, online can be done anywhere, she can schedule a time
for herself each day when it fits into her day. Doesn’t have to take a large

portion of time out of day. With all the other things that it takes to lead a

healthy lifestyle- time is an issue.

 

G3

Support whenever it is needed. Don’t have to wonder, can just ask. Can
gain others insights from convenience of home. Know it is available even

if not using it.

 

M4

Always available- feels like she can always ask, always learn something,
like she's not losing any learning or contact time with the professionals or

her peers.

 

N5

 

 

Available when she needs it 24/7, not just when face-to- face classes are

 

4l

 

 

scheduled. May need support at various times of the day

 

S6 Uses computers all the time anyway, chat rooms and things like that

 

 

 

 

All interviewees reported that they found the eweightmanager to be convenient
and that the convenience was an important factor in their continued as well as initial use
of the eweightmanager. Four respondents reported that it was difficult to make the face—
to- face classes due to one of several factors; the long commute after a busy work—day,
the inclement Michigan weather and the lack of flexible times that face-to- face groups
are held. A2 responds, "my schedule is busy and I thought versus driving to a class that I
would just go to the web site".

The interviewees who had young children at home acknowledged the convenience
of getting the support or interaction whenever it was needed and being able to do it from

home the time of the day that best fit their schedule.

Group Interactions. Sharing interactions that occur between learners or learners
and facilitator. These interactions may be face-to- face or online.
Table 5. Summary of responses regarding interactions with other learners or with

the facilitator in a face-to- face or online group

 

Interviewee Interview

 

81 By reading other learners' responses it feels as if she's listening to a
conversation, which stimulates self-talk. Discussions in a class are
helpful, sharing ideas and gaining insight. She considers leaming to be

the sharing of ideas. She feels comfortable speaking up in a group,

 

 

 

 

42

 

however, less people participated in the discussion as the program went
on - maybe they felt comfortable with what they were doing and just did

their thing and left.

 

Maintenance participants who come to the face-to- face classes were
negative, they judged based on physical appearance. It was helpful when
online to have a dialogue instead of waiting to be responded to in a day
or so. Helpful to read individuals posts on how they cope / make choices,
etc. She enjoyed the facilitator redirecting or challenging some
participants. Unfortunately people have a tendency to be negative in a
group. She's much more interested in the answer from the professional

and how this may change her behavior or a choice.

 

G3

Practical experiences and ideas for coping and dealing with difficult
situations are very helpful for keeping her interested in sustaining a
healthy lifestyle. With online learning it is nice to get feedback when
asking a question, making a comment or observing. Constructive
feedback is helpful, if worded correctly. Can appear to be criticizing if
pushed too hard. Confrontation in a discussion can cause the learning to
subside. Others experiences are valid especially if going through the
same thing. Feedback helps make an idea valid. It is not a negative thing

to be the only one talking in a group.

 

 

M4

 

Connecting with other people and reading what they say or think is a
learning experience- It's nice to be heard in a group or understood, which

reaffirms her thoughts. She has a difficult time expressing herself - it is

 

43

 

 

nice to have people understand her in a group.

 

N5 It is important to get a response from either the facilitator or other
learners - so she doesn'tt feel alone. If given no response it may be taken
personally. Constructive criticism is helpful especially when learners are

off track.

 

S6 Sharing personal experiences is learning. Some groups are easier to

speak out in then others depending on the facilitator's style.

 

 

 

 

Many questions during the interviews alluded to the discussion of learning
interactions. Some were positive, some negative and they occurred in both online and
face-to- face environments.

All six interviewees mentioned the benefits of sharing ideas and concepts in a
group atmosphere as an important interaction of learning. M4 discusses her experiences
with interacting online:

When given advice I consider it learning, I don’t know if it’s learning anything

about weight or the loss of it or if it’s just connecting with other people, reading

what other people see or think. Of the five different people in our class, where
every one of us is different I learned something from every one of them. [It is

nice] when you answer me and it is upbeat and I think oh, well I guess I did

answer the best I could, you know and you understood it.

Four out of six respondents mentioned feedback. When M4 was asked how she

felt while online with the eweightmanager, she states:

I’m getting my thoughts out [and] I’m not holding them in. I’ve got someone to
listen to me. I’ll get an answer and I’m very anxious to get that answer because

I’m always there looking for an answer and waiting 2-3 days is not a good thing.

N5 discusses her insight on the importance of feedback on an emotional level:
...I think that it is important that the staff responds. . . so you’re not feeling that
you’re alone. I know sometimes, like, I just think about posting on the other
message boards [that I visit]. When no one responds people tend to get their
feelings hurt as if nobody cares and it may not be that nobody was trying to be
malicious or mean, but I’ve seen it, I’ve been on a lot of different message boards
for various topics and you’ll see someone say, ‘well no one responded to me,
maybe I should just leave this board.’ I have never had this happen to me where
I’ve gotten upset, but I think that it is important to respond.

When asked about the feedback she received. G3 responded, “. . . it made what I

was saying more valid, you know to me I would think ummm?, [but when] people would

say ‘yes, that’s how I feel too’...”.

Constructive feedback or challenging one another also was viewed as helpful

interaction. The practice of challenging one another, whether face-to- face or online does

need to be sensitive and not confrontational. GS shares her thoughts on this type of

interaction:

...When people are positive and supporting and they say yes I think that’s exactly
right and it makes you feel good [and that]... somebody feels the same way. If it

was criticizing just me then I would probably feel down about it, not a long range

45

kind of thing, but just you know [I might think], that wasn’t very nice... but if

somebody said, ‘well that’s good, but you might want to try this’ then that could

be a little bit more constructive. I think we heard a lot of this in the entire

program, because that’s how you learn.

Role of a facilitator. What is the role of the facilitator in a

group learning environment, either face-to- face or online? Interviewees share their

experiences and expectations.

Table 6. Summary of responses regarding the role of the facilitator

 

 

 

 

 

 

 

 

Interviewee Interview

81 Knowledgeable, but not the end all is all to a discussion occurring. Keep
the conversation truthful with some sort of direction.

A2 F acilitators' role is the most important. They can turn a negative comment
into a positive constructive comment. She's interested more in what the
teacher has to say then the students because she wants to know the
answer.

G3 Their role is to overlook and make comments, comments help validate the
learners' thoughts and ideas.

M4 They should be open- minded, able to comprehend ideas and thoughts.
To be positive, personable, approachable and able to get their message
across. Helpful if the facilitator was/ is known also in a face—to- face
situation.

N5 A moderator for the interaction between peers and to keep it polite and

 

46

 

 

truthful. To keep it at a professional level. To comment, especially if
other learners are not commenting- learners begin to feel alone if no one

comments.

 

S6 To guide the discussion to prevent, “going off on tangents"

 

 

 

 

All interviewees responded to the role of the facilitator as being important to their
continued use of the eweightmanager. Helping with direction and providing professional/
truthful feedback is necessary. The presumed role did not change based on the group
being face-to— face or online. However, the importance of feedback was stressed in an
online environment. For both keeping things positive as well as keeping learner’s
engaged in a non-human touch environment. ND responds:

I think that it is important that the staff responds [vs. relying on peer interaction]

so that you’re not feeling like you’re kind of alone. When no one [peers]

responds it is important that the facilitator respond some how.

Only one interviewee reported the facilitator’s role to be most
important, over the interactions between learners. This respondent is more so interested
in gathering correct information than processing the information, which was not the
consensus of the six interviewees. 8] explains the facilitator’s role in her opinion:

I’ve facilitated groups with work and I certainly hope that my role is important,

not the end all be all, but someone has to either throw a bit of truth or knowledge

or fact into a discussion gone wild.

47

Motivation to continue learning. The factors that keep a learner interested and

motivated to continue the learning process. The data collected is related not only to the

weight management learning process but any life experience.

Table 7. Summary of responses regarding what keeps a learner interested and

motivated to continue learning?

 

Interviewee

Interview

 

Sl

It has to benefit others and be of interest to her. She also likes to be
challenged and if she makes the conscious choice and sets her mind to it

that can be a challenge.

 

Commitment and being able to relate to the subject matter. There also
must be a reason for the learning, even if just to become better at
something. She considers herself to be self-motivated and she will
problem solve until she figures it out, she enjoys seeking out new

knowledge. Interest in the subject matter is also important.

 

G3

Desire and enjoyment have to be present. When she does well at

something she enjoys and therefore wants to continue.

 

M4

Determination not to fail - her age and the mistakes she has made,
knowing that she has to keep going, a driving force. Health and work,

there must be a reason to learn.

 

N5

When she accomplishes small reachable goals it helps her to stay

interested

 

S6

 

 

Does it relate to her current life stage

 

48

 

Four out of six respondents mentioned having an interest in something, as a factor
in their motivation to continue learning. A2 discusses her motivation to learn:

If I have a flat out interest in something, like traveling... I like to read about

different countries. If it's not a personal interest it is generally tougher to stay

focused on it and I have to make a commitment to sitting my butt down and
learning it.

Learning must also be contextual. Half of the interviewees reported that there
must be some sort of reason for the learning to occur or that it must be relevant to their
life experiences. When asked how she stays interested in the learning process, S6
responded:

Relevant, absolutely it has to be relevant and it has to pass the relevancy test for

me because if it is not relevant to my life or my particular situation then no I'm

not interested... for example journals that target the 18-34 year old women of

child bearing age hold little or no interest to me even though they might have
articles in there on weight management, but they are likely to be . .. recapturing
your body after childbirth and how to manage breast feeding, things like that

Self -eff'rcacy or doing well at something was also mentioned as a motivator for
learning. G3 states a reason for her staying motivated in the learning process of weight
management was, "I guess because I knew I was doing well... therefore I looked forward
to every Tuesday [the night I had class]".

N5 reports that reaching small reachable goals helps keep her interested.

Making a commitment and determination were mentioned by half of the respondents as a

reason for continued learning. M4 relates her commitment to her age and her

49

determination to not fail. A2 states, " I need to learn it to perform the best at my job

because I like to be the best".

Support. Respondents describe feelings of support, feeling safe, being

understood and not feeling alone.

Table 8. Summary of responses regarding feeling safe, understood and not alone

 

Interviewee

Interview

 

81

Having the eweightmanager available is like a safety net. Most important
thing she has learned on the ewightrnanager is the reassurance that what

she's doing is OK.

 

A2

Eweightmanager allows for asking questions of other learners regarding

their coping and difficult situations

 

G3

She expects the eweightmanager to be a community that she can visit and
always feel welcome. It is available whenever she needs a resource,

information or a listening ear. She thinks of it like a personal friend.

 

M4

The eweightmanager allows you to not feel alone, that other people have
problems related to weight also. Feel accepted with like people. Reading
others' responses can be supportive to your own actions. Felt good to be

typing out all of her thoughts.

 

N5

 

 

Eweightmanager allows you to learn from others who are in the same
situation and what hurdles they may have overcome. To know that you are
not alone, wrong or a horrible person. It's nice to have the positive

feedback and a buddy for positive feedback

 

50

 

 

S6 Thought eweightmanager would be helpful to support her efforts for

weight management success. To gain insight from others.

 

 

 

 

Feeling supported, understood and not alone was a major benefit of participating
on the eweightmanager noted by all interviewees. They explained it as a sense of "
community" or a "safety net". Knowing that other people were struggling with similar
situations was a comforting feeling. N5 explains how she has gained support fiom the
eweightmanager:

You know sometimes after a rough day or, you know, sometimes it helps to get

online and just see [how] other people may be going through the same thing, like

during the holidays... it is helpful to hear fiom other people who are in the same
situation... how they overcame hurdles. [By participating] I don't feel alone and

I'm not the only one feeling a certain way. It reassures me that I'm not wrong or

you know, a horrible person. It's sort of nice to have a buddy in all of this and just

have some positive feedback.

Five out of six respondents are using the eweightrnanger
for a resource. They are asking peers and/ or the facilitator questions to gain knowledge
or insight. 81 comments, " I can just click on it when I need extra support or to see what

the schedule is to see if I can make it in for a face-to- face class" .

Experiences and feelings related to technology. Experiences and feelings

regarding technology (the computer) and how these feelings relate to online forums like

the eweightmanager.

51

Table 9. Summary of responses regarding experiences and feelings related to the

computer or the technology involved with online forums such as the

 

 

eweightmanager
Interviewee Interview
S1 Initial thought of eweightmanager, a bit apprehensive due to her age and

her generation not being as fluent with the computer as her professional

peers

 

She loves the idea of getting online, she does everything online - very
comfortable with the Internet. When first attempted the eweightmanager,
she didn't understand the point - not enough direction. Would recommend
organized chat rooms for immediate response from facilitators - could
easily be scheduled into a busy day. Initially not enough postings from

participants and therefore, she lost interest.

 

G3

She likes the Internet; she's comfortable with ordering things and email,
etc. She iked the feedback- there is some lag time but once she received

the feedback it was really nice

 

M4

Initially she didn't understand all the avenues to get information, more
benefit then she realized. She really likes to type - she can think about it
and read it over - she's enjoyed this her whole life. Very frustrated when
she couldn't get on - due to programming issues, this only happened once.
It would be difficult if participants didn’t know one of the facilitators.

[However this is not the case with the eweightmanager]

 

N5

 

 

She has a lot of familiarity with message boards, etc. online. She's always

 

52

 

 

found them helpful.

 

S6 She uses the Internet all the time chat rooms, email etc. F rustrating
because the eweightmanager does not have enough interaction /
participation. The site was very difficult to use, which is ridiculous since
she doesn't consider herself computer illiterate - it disappointed her
because she liked the concept. Suggested an introduction to the

eweightmanager [there now is a instruction sheet/ link available]

 

 

 

 

Five out of six interviewees feel " very comfortable online." They have much
practice with email, ordering things online and some have ventured out to other chat
rooms or discussion forums.

Technology based learning also has some limitations. Apprehensions to this style
of learning include: not being from the generation where computers are the norm, not
enough direction, too much lag time between interactions (unless on a live chat room),
and the lack of face-to- face interactions. Both S6 and A2 share their negative
experiences with the eweightmanager and the technology of learning online. When asked
how she felt while being online with the eweightmanager, S6 reports:

Actually my recall on that is that it was fi'ustrating because I couldn’t seem to find

comments from more then one or two people and I think at the time I thought this

is silly, this is not going to work if I can’t manage to get what I need, ummm, If I

can’t even find comments from people on it then I will email the administrator of

the site and tell them that I find it very difficult to use and that what I had

expected was that I would be able to quickly see everyone’s comments on a given

53

topic - and I just didn’t. I wasn’t able to get through the process. I just thought it
was awkward to use and I ended up just getting nothing much- I was frustrated...
however, if I could manage to use it I should be able to learn something fiom
other adults.

A2 responded to the same question:

I felt alone. It was like I didn’t understand it, typing

into something, nothing. I really didn’t even know what to ask, because I wasn’t

clear who was answering the questions. I never got back on after that experience.

External vs. internal benefit. Experiences and feelings of gaining external vs.
internal benefits from participating in the eweightmanager online forums.
Table 10. Summary of responses regarding experiences and feelings of gaining

external vs. internal benefits from participating in an online forum

 

Interviewee Interview

 

81 She didn't expect to learn or pick up new facts. She's after insight, how
people are getting through and some reinforcement - an internalized gain

not physical.

 

A2 She found this type of interaction an internal benefit, just by talking to

others about how she was coping.

 

G3 Initial thoughts of online learning were the benefits of sharing. Initially
thought of it as only internal support but realized that internal support rolls
over into motivating positive external support like before eating a piece of

cake.

 

 

 

 

54

 

M4

She doesn't feel this type of environment will be in depth enough to gather
physical / factual information re: nutrition, etc. she enjoys getting her
emotions and thoughts out - she doesn't have to stop until her mind is

clear

 

N5

She considers this type of environment to help more with internal aspects,
just because she is making an attempt to focus less on the scale and
looking more for changes within. But she think that probably both would
be effected, it is necessary to have the external information to help her
internally with the whole weight management situation. She wants to
learn to recognize her intuitive signs for hunger rather then take a pill to

control it

 

S6

 

 

She didn't expect to learn any new factual diet information, it is purely an

emotional support kind of thing for her.

 

External benefits are defined as gathering factual information such as weight,

calories and recipes. Internal benefits are defined as learning intuitively such as

reflection, self-care, identifying internal body signs and emotional cues.

All respondents identify their participation in the eweightmanager as an internal

gain. G3’s initial thoughts of online learning were:

I thought of it as more of an internal support, but you know, I guess as we’ve
learned [in the program] one rolls over into the other, umrn, if you are feeling
confident and ask a question, then in the end you get that little bit of motivation to
think before deciding to pick up that big piece of cake or whatever- so I think that

they [internal and external] work together.

55

 

N5 states, “I want to learn to recognize my intuitive signs for hunger rather then

take a pill to control it”.

Discourse and having the opportunity to get out feelings and droughts were an

internal benefit mentioned by five out of six respondents.

Online learning vs. face-to-face learning. Experiences and feelings are shared

when comparing face-to- face vs. online learning.

Table 11. Summary of responses regarding different experiences and feelings with

face-to- face learning vs. online learning

 

Interviewee

Interview

 

S1

Face-to- face learning is easier to just say it and acknowledge that it was

said- Online learning causes you to think more about a response first

 

Comfortable talking in a group, she's very open- however secondary to job
position it can be odd to be seen in a group, others in group may feel
inhibited as well as she may feel uncomfortable. A benefit of online

learning is the animosity.

 

G3

When online she feels more able to speak up, more confidently in what
she's saying. Online it is easier to get a point across, face-to- face can be
more difficult since you can't delete. She always has a lot to say in face-
to- face groups, sometimes she felt like she was the only one talking.
Online it is different because you are not aware of people sitting back and

not participating in the discussion.

 

M4

 

 

She needs the face-to- face contact- she wouldn't choose to do an online

 

56

 

 

only program. Initial thoughts were not good - she doesn't retain things
well she need to have verbal talk rather then reading. It is a lot easier for
her to type than talk. Online learning eliminates the facial expressions
associated with communicating - this can be a good or a bad thing. After
meeting a person face-to- face and having a bad initial meeting she would

not feel comfortable communicating with them online.

 

 

 

 

N5 In face-to- face groups people can monopolize. She feels equally able to
speak up online or face-to- face- however she doesn't notice monopolizing
behavior online.

S6 In face-to- face groups she would consciously not speak up due to the

concern for monopolizing the group - secondary to her facilitating
experience it can be difficult to just enjoy the conversation, she tends to be
critical. Online there is no feeling of being watched - the fear of speaking
up in front of a group. Also with weight consciousness people - online

communication could be easier.

 

When asked about their ability to speak up in group three out of six interviewees

commented on the feelings of the group discussion being monopolized. This was felt

secondary to some participants visibly and obviously not interacting and others taking

control of the group discussion. This was viewed as a flaw in the facilitator’s

competencies. G3 comments, “I haven’t really felt [the monopolizing] online because

you don’t visually see the people sitting there not participating."

57

 

Animosity is mentioned as a benefit to online learning by two out of six
interviewees. Secondary to work/ professional status and the weight consciousness of
individuals in an face-to- face group, the autonomy of online groups can enhance ease

and comfort with communication.

58

Chapter V
Conclusion and Recommendations
Discussion

The subjects in this study discussed their reflections with an online learning
environment. In particular each interviewee has participated in the eweightmanager, an
online discussion forum for ongoing weight management support. The basis for this
study was to gain insight from the learner's perspective, an 'enric' or insider's perspective
as the phenomenon emerged from the data (Patton, 1987). The following strategies were
inductively explained as themes emerged from the data: 1) online learning 2) the
components of learning style and 3) cognitive behavioral therapy intervention for weight
management.

1) The first concept being that the components of online learning can compliment
the non- traditional style of learning as well as provide an environment for weight
management support and the application of learned knowledge.

As the literature displayed there are many advantages as well as some limitations
to this style of learning. The advantages of an online learning environment include:
flexibility (learning that is time and place independent- with asynchronous learning), self-
paced learning, affordability and a positive significance within today’s communication
culture. Not surprisingly, many of these advantages also represent potential limitations
for learning. The time-independence feature of asynchronous learning can be very
beneficial for a busy schedule. However, it can be a drawback in situations where
problem solving and feedback is time sensitive. The self-pacing benefit also may be a

disadvantage for learners that are unable to self- motivate or self- direct. Technology

59

itself can impose the greatest limitation. If learning systems are not user fiiendly learning
can be hindered by preventing the development of a positive attitude toward the online
learning environment (Chute, Thompson and Hancock, 1998).

All interviewees responded to the benefits of the flexibility involved with the
eweightmanager. N5 comments on how the flexibility has benefited her:

[when online], I feel like I’m taking control, it’s my time... I’ll do it at work when

I get a break or late in the evening when the kids and my husband are asleep... it

makes me feel like I’m putting myself first for a moment without neglecting or

hurting anybody else.

Self-paced learning was also noted as a benefit. M4 responds, “ I can think about
it and read it over and then post it”.

However, limitations were also noted as several interviewees verbalized
frustration with infrequent peer interactions and postings. This in part could be due to a
lack of self- motivation and direction by participants. A2 states, “initially there were not
enough postings and I lost interest".

Time sensitive responses were mentioned by three out of six interviewees.
Otherwise participants "feel alone," like they are "typing into something and I really
don’t even know... who is answering ".

When interviewees discussed their experiences with learning and the Internet,
online asynchronous learning was predominantly viewed as a positive experience. When
compared to face-to- face learning the animosity of the learner was beneficial, especially

for those individuals seeking weight management support. S6 responds:

60

Everybody turns around and looks at you [in a face-to- face group], and in the
case of people working on weight management, you don’t want people to look at
you because of your weight, but speaking online people wouldn’t feel as shallow.

As Van Gelder (1996) argues, it is in the absence of this face-to- face contact that
intimacy can be enhanced. The concept relates to the phenomenon that it is easier to talk
to a stranger in the form of a counselor then someone who was known previously.

The monopolizing of group discussions was a concern with five out of six
interviewees with face-to- face groups. However, this was not felt with online groups.
Regardless of the amount of participation that had occurred, it was not as readily obvious
in an online group, therefore feelings of monopolizing were less apparent.

Palloff & Pratt (1999) recommend that in order to engage learners in the online
learning process and to encourage the meaning making process that is part of the
constructivist approach for learning the content should be embedded in the learner’s
everyday life. The process of connecting real life experiences to learning can provide a
sense of empowerment for individuals validating themselves as people who possess
knowledge and who can apply what they know in other contexts of life.

S1 comments on how she maintains her focus and awareness by using the
eweightmanager to encourage day-to-day accountability by setting goals. She also
mentions how setting these day-to ~day goals helps her to be realistic, which decreases
the likelihood of disappointing herself.

2) The second concept that evolved is that learning style can affect the learning
process in which weight management efforts take place.

Collaborative learning has a strong social response and takes place not

61

from the books or facts that are read but the influences and the discussions that occur in a
group (Bruffee, 1999). All interviewees responded on the importance of discourse for an
optimal learning experience. Interviewee G3 comments on her experiences with
learning, "I didn't even know how to do it, but from looking at it and talking about it with
others and making some mistakes, I figured it out."

Merriam & Caffarella (1999) support this theory by defining collaborative
learning as relevant and applicable to the learner's current or desired lifestyle. Dewey
(1938) implies similarly that learning is not simply gathering information but to rather
bear upon our everyday actions and behaviors. Interviewee S6 explains how she stays
motivated to continue learning: "relevancy, absolutely it has to be relevant... if not
relevant to my life or my particular situation then I'm not intereste ".

Because the eweightmanager can be visited from anywhere there is Internet
access; the questions, concerns and insights are most often relevant to the learners
immediate situation. Interviewee G3 comments are her use of the eweightmanager
depending on her day to day activities," . .. whether we are traveling or going to an event,
you know I know it is available and I'm thinking about it, I'm always aware. It's helpful
just knowing it is available, even if I don't use it".

It became obvious through the interviewees responses that an online environment
is an appropriate and possibly an ideal place for contextual learning to occur. The
relevancy of learning contextually encourages meaning and learners are more motivated,
interested and achievement driven (Hansman, 2001 ).

T ransfonnative learning is rooted in the constructivist theory and refers to

learning as reflection and the interpretation of experiences, ideas and assumptions that are

gained through prior learning (Mezirow, 1990). The assumption that participants in an
online supportive environment would learn in this way was also proven true. All
interviewees considered their learning or hoped for their learning to be an internal gain
versus an external gain. They described this happening through sharing and hearing the
insight of others. Interviewee 81 comments on her expectations from participating on the
eweightmanager, " I guess what I'm after is insight, how are people getting through and
maybe as well some reinforcement as to what I'm doing is fine".

Knowles (1975), supports these ideas and the use of reflection, exploration and
collaboration, suggesting that learners are motivated by internal incentives, such as self-
esteem, achievement, personal growth, sense of accomplishment and curiosity.

3) The third concept is that cognitive behavioral therapy can be appropriate
intervention therapy for weight management success and the application of learned
knowledge.

Considering the recommendations for cognitive behavioral weight management
therapy are different than those for initial weight loss, an online supportive environment
can prove to be very beneficial. Weight management requires a special emphasis on
viewing eating as a choice, self - acceptance and an abandonment of purely external
factors as a measure of success. Inherent calorie restrictions as well as calorie and weight
obsessions are discouraged (Cooper and Fairbum, 2001). Learning has to become
internalized and should become a part of the learner's life not just an external measure of
success.

The experiences and feelings of the interviewees in the online environment were

in agreement with these recommendations. Five out of six interviewees noted that they

63

enjoyed gaining insight from others. They also discussed the benefits of being able to
problem solve with other learners and/or the facilitator. Interviewee G3 explains her
interactions with problem solving or interacting online:
...if you have a concern or a question and you ask somebody, in the end I think
you feel more motivated, more confident. Which helps when you are making the
choice to sit down and eat cake or whatever... you know I might respond [to
someone online] ‘oh, you know that is a good idea, yeah I might, you know try it
that way, although this seems to be working for me’. i-

Interviewee S1 explains that when she is on line reading the responses of others it

 

feels as if she is participating in a conversation which then stimulates- "talking to myself,
saying I couldn't have done that but I could have done it this way ."

Reflection and positive self talk are skills that encourage the practice of,
controlling choices and behaviors without the need for detailed external monitoring
systems. This is a practice that is necessary for long- term weight control (Cooper and
Fairbum, 2001). When asked about gaining external or internal benefits from an online
learning environment all six interviewees responded that they have gained internal
support. N5 responds:

Umm, my expectations and experiences have been more internal, just because

umrn, I try not to focus on the scale and all of that so I guess I'm looking more for

changes within. . . more for how I can control the whole weight management
situation and that this information can help me internally so that I can be less
reliant and so that I'm my own kind of force and base. I want to recognize my

own hunger signals rather than having a pill do it for me.

The data collected from the six interviewees reinforces the concepts of
CBT for weight management success. The eweightmanager is part of the intervention for
the weight management phase of the program. The concepts of CBT recommend a
different approach for weight loss and weight management to provide overall, long term
management success (Cooper and Fairburn, 2001). The eweightmanager appears to
provide some of CBT’s ideal components; peer-support, independent problem solving,

self— control, reflection and critical/ constructive evaluation of self and peers.

Limitations

The sample size, although appropriate for the research design and the criteria for
which the sample was selected can still be considered small. More importantly the depth
and richness of the data may have been improved with a greater time allotment from the
researcher / interviewer. Probing and a following up interview could have provided a
more thorough understanding along with a list of specific recommendations for this type
of online learning environment. Rather, then the general recommendations that came of
this research.

Biases may have been present due to my prior acquaintance with each
interviewee. I had met each interviewee previous to the interview in a professional
manner as their counselor or educator in a group or one-to-one situation.

Not all nominees who were called on in this study agreed to participate. After the
purposeful criterion sampling, twenty-five invitations were sent out and six responded.
These six individuals became the interviewees for this study. One might question whether

these nominees that didn’t respond were potential key informants.

65

Criterion sampling may not be thought of as a true representation of all
eweightrnanger participants. However, the objective of criterion sampling is to describe a
sub group in depth. This sample selection makes most sense with the research design that
was chosen. The recommendations that arise from this study will be relative to those
individuals who have completed a structured weight management program, who have lost
some weight (at least 10% of their initial body weight), made a personal commitment
(scheduled at least one consult visit with a health professional) logged onto the
eweightmanager at least three times and responded to a forum discussion at least once.
This sub-group is defined as self-motivated with increased self-efficacy due to their
taking charge and making personal choices. The limitation could be that this group is
considered, prime pickings. However, this sub group was chosen due to it being the most
appropriate for obtaining useful and meaningful data from which recommendations could

be made.

Conclusions

Though I can not conclude that an online learning environment is the optimal
method for gaining support for all weight management participants, the research did
prove that for self-motivated individuals who hope to continue making personal lifestyle
changes the online environment can prove to be very beneficial.

Respondents in this study found the online environment to be convenient due to
time and place in-dependency. They also felt safe belonging to a group of individuals
with like concern, having the professional/ peer guidance , the“ buddy system”, the

reassurance and the animosity that it could provide.

66

The online environment is an avenue that allows for open communication, social

reinforcement, information exchange as well as an opportunity to increase self-esteem

and self-efficacy. The respondents in this study found the sharing of real life contextual

information to be beneficial to their sense of engagement toward their new lifestyle

change.

The outcomes of this research allowed recommendations to be made, based on the

experiences of online learners, for future planning and coordinating of online supportive

environments for weight management success.

1)

2)

3)

4)

The computer program or website that is being used should be
user friendly including a detailed list of instructions and/ or
directions. Ideally there should be a preparation class either
online or face-to- face, allowing hands on learning to occur.
Administrative support needs to be available and open to
feedback from participants.

The facilitator should provide clear expectations for the online
learning environment. For example, how to interact, how often
and with whom. Ambiguity with how to give feedback can lead
to poor interaction between peer learners. Peer feedback needs
to be encouraged and may take much probing fi'om the
facilitator.

Feedback from the facilitator and/or peers has to be timely (
within 24 hours), positive and / or constructive. Some type of

feedback is very important.

67

5)

6)

7)

The learning environment needs to be safe and comfortable.
Comfortable to speak freely and openly. Participants should
never feel judged. If the participants have a common interest
and / or are coming from similar life experiences this can help
make it a comfortable environment. It is the responsibility of
the facilitator to keep it professional and supportive.
Participants should be given guidance on how to interact. An
internal gain should be expected. The facilitator may need to
challenge participants to take this step. It is easier and more
expected for participants to focus on external motivators.

The facilitator should take care not to take the lead and to stay
in the facilitator’s role. The facilitator's role is to participate as
a learner not to be the knowledge vessel but rather to share and

encourage sharing of experiences for learning to occur.

Future Research Opportunities

 

The study provides in depth qualitative data based on learner experiences. From
this data themes emerged and valid assumptions were made which led to a
comprehensive list of recommendations. However, to make further impact in the arena
of weight management, online learning and learning style there is opportunity for future
research. With the data collected and conclusions made from this research, a
comprehensive program could be developed based on the needs that were voiced by the

learner, an emic perspective. A comparative study could be performed with two groups

68

of online weight managers: one using an online / collaborative approach and one using an
online knowledge resource approach. The outcomes could help to better understand what
the needs of the weight manager truly are, an internal support or assistance with external

monitoring?

69

Appendix A
Recruitment letter:

October 3, 2003

Melissa Tolan—Halleck RD
300 N Clippert Suite 15
Lansing, MI 48912

To whom it may concem—

My name is Melissa Tolan-Halleck, and I am a graduate student at Michigan State
University. I am working on research related to online education and program
implementation. As the program coordinator of Sparrow Weight Management Center, I
am writing to ask your assistance in providing information that could be very helpful
toward improved program development and weight management intervention outcomes.
Your time and honest feedback will be beneficial to my efforts and appropriate
programming in the future.

Your participation in this study is voluntary. The study will consist of one short
interview and participation in Sparrow Weight Management Center's eweightmanager,
the online component of the maintenance program which is at no additional charge to
you. Participation in the eweightmanager discussion board forums is at your discretion,
the time commitment is variable depending on your desire for participation. The
interview process will take about 2 hours.

It is important that you understand that your participation is completely voluntarily and
will have no affect on your relationship as a patient with Sparrow Weight Management
Center. If you are interested, in participating, please contact me by phone or email by
November _2003, you can reach me at 364-8086 or melissa.tolan@sparrow.org.

The confidentiality of your information may be a concern for you, I ensure your
confidentiality in any analysis and report. I will be the one analyzing and writing the
report, and therefore, after the report is written all documents with your name or address
will be destroyed. Your privacy will be protected to the maximum extent allowable by
law.

Thank you in advance for your cooperation. Please feel free to contact Dr. Robbert
Hugget, Chair of the University Committee on Research Involving Human Subjects at
(517) 355-2180 if you have questions about your role and rights in this study.

Sincerely,
Melissa Tolan-Halleck

70

Appendix B
Interview Guide
1. Why did you choose to sign up for the eweightmanager?

o How did you hear about the eweightmanager?

o What were your first thoughts about the idea of online learning?

2. What expectations do you have for the eweightmananger?

0 Internal and external? (To increase internal motivation- how? or obtain

 

IF I29" ’1.--“ 1

external goals- how?)

3. How do you feel when you are online with the eweightmanager discussion
board?
0 How does this participation help or hinder your state of mind
0 Do you feel this participation effects your day one way or another- and

how?

4. How do you most like to learn?( in general)
9 To talk and participate or to listen and absorb... ?

o What keeps you interested in a subject matter? ( with learning in general)

7]

. What you are doing online with the eweightmanager, do you consider this
learning ?- please explain.
9 What is the most important thing you have learned since being enrolled in

the eweightmananger?

. How have other online group members affected you (positive or negative) and
your weight management efforts?, please explain.
How did you participate?

Did you receive feedback from others, what did this feel like?

. Is the role of the facilitator or discussion board administrator important to
your continued use of the eweightmanager? Please explain.

What did he/ she do to help or hinder your weight management efforts?

. Overall how has your experience with the eweightmanager affected your

weight management efforts?

= probes

72

Appendix C
Contact Summg F orm

Contact type: Interview With whom: S1 Interviewer: Melissa Tolan-Halleck

Site: Conference Room
Contact Date: Today’s Date: 3-20-04

1. What are the main issues or themes that struck you in this contact?

0 Consider age and degree of experience younger peers have with techno
sawy stuff

0 When focused it is easier to concentrate on the day to day, which
decreases the chance of disappointing self.
EWM inspires self talk
Face-to- face is ideal but EWM like a safety net- when unable to make a
face-to- face class

0 Enjoy learning through discussion and it has to be relevant. A challenge
enjoyable and a conscious choice help keep interest in a topic

0 Facilitators role is important with keeping the discussion organized and
factual, SJ is a facilitator and hopes her role is viewed as important also,
but not the end all.

2. Surrrrnarization of information obtained or not obtained, based on each focus
question

 

Question Information

 

Expectations of EWM Convenience and to keep contact were
reasons for signing up. Expectation is help
maintain focus on new healthy lifestyle,
gain support and use as a resource for
schedules of classes ect.

 

Initial thoughts of EWM Intimidated secondary to age and younger
colleagues being very techno sawy, but
also realized it could be a great way to
communicate with others without the
inconvenience of driving out of my way.

 

 

 

Internal vs. External learning To gain insight, reinforcement- not to learn
new facts

How has actual participation online Inspires self-talk when reading or

effected weight management efforts responding to the forums. Convenient,

however face-to- face is best but having
EWM available allows for a safety net
when unable to get to face-to- face
meetings. EWM has allowed for easier
connection/ focus of goals, it is there when
I need it. It has allowed me to stay focused
day by day- a realistic expectation, which

 

 

73

 

 

 

decreases the chance to disappoint myself
by breaking my plan. The most important
thing I have learned from the EWM is

support and reassurance. Has not hindered

 

efforts
Learning; style, enjoyment, continued Learn through discussion, this is what I
interest in a subject know; it is how we learn at work. I talk in

a class situation as often as needed. When
feelings of frustration come up, discussion
is a way to let it out. To stay interested it
has to relevant, enjoyable and a challenge.
A challenge that I have made a choice to
commit to.

 

 

Viewed role of the facilitator on the EWM Yes- to help organize the conversation and

 

provide factual information

 

3 Additional interesting points

SJ likes a challenge- she considers learning a challenge

Online learning takes more thought- always think before putting
something in writing.

FACE-TO- FACE learning easier b/c you acknowledge what you are
saying as you say it

Desires more focus on her self with this lifestyle change- rather then focus
on external dieting practices

4. What new or remaining questions

74

 

Contact Summary Form

Contact type: Interview With whom: A2 Interviewer: Melissa Tolan-Halleck
Site: Conference Room

Contact Date:

Today’s Date: 3-20-04

2. What are the main issues or themes that struck you in this contact?

Love online learning, very comfortable with it

Like EWM idea and not needing to be physically present, self conscious
of others perceptions secondary to less weight to lose.

Expected to get answers to questions from professional staff

Negative experience with EWM secondary to participation only during
first several weeks- and still working through technical issues

Felt alone when online

Easily distracted, I need to read in order to absorb it

Commitment and interest keep me interested in learning

View facilitator as the teacher with the knowledge to share

Positive aspect of online vs. face-to- face is the anonymity

2. Summarization of information obtained or not obtained, based on each focus

 

 

 

 

question

Question Information

Expectations of EWM Easier method to stay connected and do the
maintenance phase of the program- also
more convenient with busy work schedule
and location. Expectations to ask questions
and have them answered by staff

Initial thoughts of EWM Initially loved the idea- very comfortable
with the Internet. Liked the idea of not
having to come to face-to- face classes- due
to negative people.

Group interactions FACE-TO- FACE groups could be

negative, felt judged due to physical
appearance. Discussion in face-to- face
groups were beneficial, would often learn
just from listening and responding to
others. Barrier could be that colleagues
may be present in-group - due to a large
health organization, anonymity online is

 

 

 

nice.
Internal vs. External learning/ motivation Hoped to get insight from others- how to
to learn they deal or cope
How has actual participation online Felt alone- like I was typing into some
effected weight management efforts nothing- it was very unclear how to use it.

 

Overall no negative effect on weight

 

75

 

 

management efforts, people were positive
and if not the facilitator brought it around
to be a positive learning experience.
Helped to see how others reacted to
different situations and how the facilitators
responded. I have learned to stay engaged

 

Learning; style, enjoyment, continued Read it in order to absorb it- although
interest in a subject discussion is good- I like to talk, but I'm
distracted very easily. Consider weight
management efforts learning. To stay
interested in a subject I have to make a
commitment and it has to be interesting- I
like to problem solve if there is a better
way to do things. Comrrritrnent if not
personal interest- I'm a goal setter and goal
achiever. Seeker of knowledge- I like to

 

 

 

 

know wghy. ..
Viewed role of the facilitator with the Most important role- I want to know the
EWM answer- peer learners help get more out of
the facilitator

 

 

3 Additional interesting points
9 Suggested having more introduction to EWM in a class format prior to
maintenance phase
0 Set time for chat online would be nice for busy schedule and desire for
immediate response
4 What new or remaining questions

76

Contact Summary Form

Contact type: Interview With whom: G3 Interviewer: Melissa Tolan-Halleck
Site: Coral Gables

Contact Date:

Today’s Date: 3-20-04

What are the main issues or themes that struck you in this contact?

Hoping to gain others' experiences, ideas reactions from the EWM
Support whenever needed was appealing, finished the program but knew I
was far from done

Comfort with the Internet

Feelings of freedom and openness when online, ability to just "let it all
out"- when speaking it is difficult to " delete and go back"

Negative comments and whining would make me feel bad however
constructive comments are OK - but not criticizing.

Not confrontational - would "back off" from situation

Comfort in knowing that there is always support and reassurance with the
EWM

Getting ideas from others is learning

EWM as a continuation of FACE-TO- FACE groups

Hearing others' responses causes a rethinking of own actions

Feelings of monopolizing conversation would cease conversation in
groups

Internal motivation] self care encourages positive external self care

2. Summarization of information obtained or not obtained, based on each focus

question

 

Question

Information

 

Expectations of EWM Convenience, to provide a sense of

community, always available, a listening
ear

 

Initial thoughts of EWM Apprehensive, not sure what to expect- not

fanriliar with online learning- more
experience with shopping online and email.
However topic very relevant and
professional staff at the center encouraging
it eased initial apprehension. Looked
forward to sharing and having additional
resources. Positive overall

 

 

Group interactions Talked a lot in face-to- face classes- some

times would stop due to feelings of

 

 

77

 

 

 

monopolizing the group conversation.
Online haven’t felt this way- different b/c
the individuals who are not participating
are not visual to you.

 

Internal vs. External learning/ motivation
to learn

Hoping for internal gains- but realized that
internal gains benefits external motivators/
measures

 

Participation online and the effect on
weight management efforts

Online communication is open and
encourages confidence in what is being
said- easier to "let it all out". A free feeling
when communicating online- unlike when
talking face-to— face, more thought is given
before speaking" can't delete spoken
words". Participating in EWM hasn't
hindered wt mgrnt efforts- feel bad when
participants complain about program- (non-
constructive comments). Reassurance from
individuals on the EWM feels good.
Constructive feedback helps learning, and
confrontation would inhibit learning.
(EXPLORE F URTHER_ HOW SHE
DEFINES CONFRONTATION)
Comforting that a question can always be
asked- helps with awareness inspires self-
talk and rethinking of actions or thoughts.
Have gained a sense of community. EWM
is like a continuation of the face-to- face

groups.

 

Learning; style, enjoyment, continued
interest in a subject

Visual Learner, Can read and learn but
discussions are great, helpful to listen to
others ideas/ perspectives, problem solving.
To stay interested it has to be enjoyable,
have a purpose and be desirable. Doing
well is motivation to continue.

 

 

Viewed role of the facilitator on the EWM

 

To validate ideas, thoughts act...
comforting to know that someone is
overlooking things and responding

 

5 Additional interesting points
0
6 What new or remaining questions

78

 

 

Contact Smnmary Form

Contact type: Interview With whom: M4 Interviewer: Melissa Tolan-Halleck

Site: The Cracker Barrel

Contact Date: Today’s Date: 3-20-04

1. What are the main issues or themes that struck you in this contact?
9 Very rule oriented- likes structure/ causes stress if unable to follow structured plan

for the day

0 Only experience with eweightmanager was part of a class assignment
9 Sensitive to others responses/ self -conscious- like interaction but not the attention

of center stage

9 Enjoy typing, a freeing experience, not too much thought

9 Strong determination- failed at weight management attempt before will not let it
happen this time - will continue regardless of fun/ interest- for my health

0 Seeing, touching being heard are very important

Summarization of information obtained or not obtained, based on each focus question

 

 

 

Question Information

Expectations of EWM Part of class, was asked to sign on. Insight
that others are in a similar situation, not in
it alone. Acceptance. To gain others
perspectives

Initial thoughts of EWM EWM could never replace face-to- face for

me. Not good initial thoughts, constant
verbal talking is helpful for me rather then
reading. Thought it would be passive
learning rather then interactive. Initially
didn't think it would work.

 

Group interactions

Much easier for me to type then to talk in
face-to- face class. Comes easy for me to
type a response- I can review it after I type
freely before sending it. Helps to know the
person you are responding to online.

 

Internal vs. External learning/ motivation
to continue learn

See EWM as more of a supporter not a
place to get in depth information

 

 

Participation online and the effect on
weight management efforts

 

Felt good online, "fingers did the walking"
able to just type and type as long as their
were things on my mind— "easy for me".
Had a positive effect on the whole day-
getting thoughts out and not holding them
in. Viewed as time for self care- reflection
ect. .. When online participating, others
hear what I'm saying] get my point across-

 

79

 

 

this interaction feels good. Feels good to
be understood and responded to. The
potential to learn something daily- I can
always learn and/or have contact.
Technical problems are frustrating
(SHOULD PROBE INTO THIS MORE).

 

Learning; style, enjoyment, continued
interest in a subject

Enjoy learning in a small group- discussing
is good but don't like to be on stage. Keep
interest by determination - knowing that I
have to do it- age and health are factors in
this determination not to fail. She is not
sure what is driving her to continue this
learning process- she is puzzled herself but
very determined (NEEDS MORE
PROBING AND TIME). Learning must
be occurring on EWM otherwise I wouldn't
want to continue. Receiving advice is
learning. Learning new information from
others. EWM has allowed me to get
emotions and thoughts out until I want to
stop.

 

 

Viewed role of the facilitator on the EWM

 

It is their job to confront uncomfortable
situations or individuals. Unsure if
participant could get the point across to
some people. Prior face-to- face exposure
to facilitator plays a role.

 

Additional interesting points
9
What new or remaining questions

80

 

Contact Summary Form

Contact type: Interview With whom: N5 Interviewer: Melissa Tolan—Halleck

Site: Conference Room

Contact Date: Today’s Date: 3-20—04

1.What are the main issues or themes that struck you in this contact?
9 Much familiarity with message boards ect.

.9.

Working hard to diminish strict diet mentality
Busy with career and family and finding time for positive self care takes much effort
Considers weight management success, lifestyle change a long term commitment

Summarization of information obtained or not obtained, based on each focus question

 

Question

Information

 

Expectations of EWM

Convenient, fits into schedule. Reassurance
that you are "not in it alone". Learn from
others going through similar situation. To
keep focused and grounded. To challenge
the thoughts and processes of old/ bad
habits.

 

Initial thoughts of EWM

Good thoughts, I have a lot of familiarity
with discussion boards, I've always found
them useful- will be helpful to get thoughts
from others going through similar
situations

 

Group interactions

Face-to- face groups can include
monopolizing of conversation- Facilitators
were good at redirecting this behavior.
Haven't felt monopolizing behavior on
EWM

 

Internal vs. External learning/ motivation
to continue learn

Looking for more internal focus, I'm trying
to defocus the scale and typical diet
mentality. Looking for more changes
within. Empowering self with knowledge-
gained from the EWM, to make good
intuitive choices.

 

 

Participation online with EWM and the
effect on weight management efforts

 

Feels like I'm taking control- when online it
is my time to take a break from the day and
put myself 1". Would hinder efforts if
giving misinformation. Active learning vs.
passive learning, keeps me focused and
conscious. Effects my whole day by giving
me the sense of control. When having a
conversation with someone online it gives

 

81

 

 

the buddy effect and the facilitator
responding gives professional knowledge.
EWM is an extension of the whole
program, a refresher. EWM is learning
more about self and gaining information
from others by listening and sharing.
Reaffirms my knowledge

 

Learning; style, enjoyment, continued
interest in a subject

I enjoy hands on and demonstration. I also
am a big reader- I seek out all the info I can
frnd on a topic that interests me. Self-
motivated. I like to ask questions after
reading to help with interpretation. I stay
interested by seeing results- or
accomplishing goals.

 

 

Viewed role of the facilitator on the EWM

 

Important to respond - if no response at all
person may take it personal. Facilitator
should not be the only one responding, peer
feedback is also important. Constructive or
challenging response may help motivate a
person into the action stage.

 

Additional interesting points

What new or remaining questions

82

 

Contact Summary Form

Contact type: Interview With whom: S6 Interviewer: Melissa Tolan-Halleck

Site: Drollette Travel

Contact Date: Today’s Date: 3-20-04

1.What are the main issues or themes that struck you in this contact?
0 People crave high touch- some reservations with online learning due to this need

0009

Frustrated with EWM in early stages, hasn't given much time to it since.

Learn from adults own personal experiences

Critical of facilitators due to own experience as a facilitator

Feel bad that I couldn't figure out EWM - an introduction would have been helpful

2. Summarization of information obtained or not obtained, based on each focus

question

 

Question

Information

 

Expectations of EWM

Support, not my soul support but helpful.
Should be easy to use, offer solutions and
positive opinions. Time is valuable,
therefore EWM needs to be quick to work
with- otherwise I go on to the next thing

 

Initial thoughts of EWM

Comfortable with email and chat rooms,
but some reservation due to lack of face-to-
face interaction— feel face-to- face is
important. Hard to maintain if not
impossible to provide the high touch that

pemle crave

 

Group interactions

I feel comfortable speaking out in face-to-
face groups- sometimes hold back b/c I
don't want to monopolize conversation,
even though I have something to say.
Some facilitators are better then others at
re- directing discussion. I struggle with
this b/c of my experience as a facilitator. I
don't want to be the person always talking
or with their hand up. Online this could feel
the same- I'm not sure. However, the
insecurities some people have of speaking
in front of others wouldn't be there online

 

Internal vs. External learning/ motivation
to continue learn

Emotional support not to gather more
factual knowledge

 

 

Participation online with EWM and the
effect on weight management efforts

 

Neither helped nor hindered efforts-
disappointing that I couldn't figure out how

 

83

 

 

to use it. Not being user-fiiendly caused
frustration and a stop to using the EWM.
The time I attempted to participate I never
knew if someone had read my post or if I
received feedback

 

Learning; style, enjoyment, continued
interest in a subject

Reading, Investigating on my own and then
discussing it with individuals who have
different experiences- professionals or
experts in their area particularly. I stay
interested by learning everyday from other
adults and by keeping up on my reading
and investigating. Information has to
relevant to my phase in life at the moment.
"EWM could be learning if I could figure
out how to use it"

 

 

Viewed role of the facilitator on the EWM

 

Important to guide discussion- stay on task

 

84

 

REFERENCES

Allee, J .G. (1984). Webster ’s Dictionary. (1985 ed.).Baltimore MD: Harbor House
Publishers Inc.

Barab, S., & Duffy, T. (2000). From Practice fields to communities of practice.

Theoretical Foundations of Learning Environments. 1-26. Mahwah, NJ:
Lawrence Erlbaum.

Bruffee, K. A. (1999). Collaborative Learning: Higher education, interdependence, and
the authority of knowledge.(2nd ed.). Baltimore, MA: The John Hopkins University Press.

Christiansen, E., & Dirckinick-Holmfeld, L.(l995). Making Distance Learning
Cooperative. [online], http://www-csl95.indianaedu/csl95/chritia.html.

Chute, A.G., Thompson, M.M., & Hancock, B.W. (1998). The McGraw- Hill Handbook
of Distance Learning. New Yrok, NY: McGraw- Hill.

Cooper, Z., & F airbum, CG. (2001). A new cognitive behavioral approach to the
treatment of
obesity.Behavioral Research and Therapy, 39, 499-511.

Derlega, V.J., & Margulis, ST. (1983). Loneliness and intimate communication. In D.
Perlman & P.C. Cozby ( Eds.), Social Psychology, New York: Holt.

Dewey, J. (1938). Experience and Education. New York, NY: Macmillan Company.

Durham, D. S. (1988). Relating to Others. London: Open University Press

Eastrnond, D.V. (1995). Alone but together: Adult distant study through computer
conferencing, Creskill, NJ: Hampton Press, Inc.

Firestone, WA. (1987) Meaning in method: The rhetoric of quantitative and qualitative
research. Educational Research, 22(4), 16-23.

Garland, MR. (1993). Student perceptions of the situational, institutional, and
dispositional and epistemological barriers to persistence. Distance Education,
14(2) 81-98.

Golub, J. (1988). Focus on Collaborative Learning: Classroom Practices in Teaching
English. Urbana, IL: National Council of Teachers of English.

Guba, E.G., & Lincoln Y., S. (1989). Forth Generation Evaluation. Newbury
Park, CA: Sage.

Hansman, CA. (2001). Context-based adult learning In S.B. Merriam (Ed.), The New

85

update on adult learning theory. New Directions for Adult and Continuing
Educatioa, San Francisco: Jossey- Bass.

Hirschbuhl, J ., Zachariah, S., & Bishop, D. (2002) Using knowledge management
to deliver distance learning. British Journal of Educational Technology,33, 89-93.

Iscoe, 1., Hill, F .E., Harmon, M., & Coffrnan, D. (1979). Telephone Counseling via
cassette tapes. Journal of Counseling Psychology. 26, 166-168.

Kuczrnarski, R]. (1992). Prevalence of overweight and weight gain in the United States.
American Journal of Clinical Nutrition, 495-502.

Knowles, M. (1975). Self Directed Leaning: A guide for learners and teachers.
Englewood Cliffs, HJ: Cambridge Adult Education.

Merriam, S., & Caffarella, RM. (1999). Learning in adulthood: A comprehensive guide
(2"‘1 ed.). San Francisco, CA: Jossey-Bass.

Mezirow, J. (1990). Fostering Critical Reflection in Adulthood: A Guide to
T ransformative and Emancipatory Learning. San Francisco, CA: Jossey-Bass.

Mezirow, J. (1991) T ransformative Dimensions of Adult Learning. San Francisco:
J ossey-Bass.

Mezirow, J. (1997). Transformative learning: theory to practice. New Directions for
Adult Continuing Education. 74, 5-12.

Mclsaac, M. V., & Gunawardena, C. (1996). Distance education. In D.H. Jonasssen (Ed.)
The Handbook of Research for Educational Communications and Technology.
403-437. New York, NY: Mcmillan.

Mustajoki P., & Pekkarinen T. (1999). Maintenance programs after weight reduction:
How useful are they? International Journal of Obesity, 23, 553-555.

Neuman, W. L. (1994). Social research methods: Qualitative and Quantitative
Approaches (2nd ed.). Boston, MA: Allyn & Bacon.

Obarzanek, E. (2003). NHLBI Study Tests Novel Ways To Help Americans Keep Weight
Ofif [online], mJ/wwwnih.gov/news/pr/iul2003/nhlbi-14.htm

Oliver, R., Omari, A. &, Herington, J. (1998). Exploring student interactions in
Collaborative world wide web computer-based learning environments. Journal of
Educational Multimedia and Hypermedia, 7 (2-3), 263 -287.

Palloff, R. M., & Pratt, K. (1999). Building Learning Communities in Cyberspace:
Effective Strategies for the Online Classroom, San Francisco: Josssey-Bass.

86

 

Patton, M.Q. (1987). Qualitative Research Methods and Evaluation. Newbury Park,
CA: Sage Public.

Perri, M.G., McAdoo, G. A., Spevak,P.A., & Newlin, DB. (1984). Effect of a
multi-component maintenance program on long term weight loss. Journal of
Consulting and Clinical Psychology, 52(3), 480-481.

Perri, MG. (1998). The maintenance of treatment effects in the long -term management
of obesity. Clinical Psychology: Science & Practice, 5, 526-543.

Regional networking meetings: A great opportunity for learning. (2002, summer). Bight
Ideas, Novartis, 7(2).

Rubin, H.J., Rubin, LS. (1995). Qualitative interviewing, the art of hearing
data. London:Sage publications.

Saba, F. (1998). Is distance education comparable to "traditional" education? Distance
Education Report,(3).

Sampson, Jr., J .P., Kolodinsky, R.W., & Greeno, BR (1997) Counseling
on the information highway: future possibilities and potential problems. Journal
of Counseling and Development. 75(3), 203-212.

Sbrocco, T. Nedegaard, R. C., Stone, J .M.,& Lewis, E.L. ( 1999). Behavioral choice

treatment promotes continuing weight loss: Preliminary results of a cognitive-
behavioral decision-based treatment for obesity. Journal of Consulting and
Clinical Psychology, 67, 206-266.

Stuart, RB. (1980). Weight loss and beyond: Are they taking it off and keeping it off?
Behavioral medicine: Changing health lifestyles. New York, NY:
Brunner/Manzel.

Tinto, V., Goodsell-Love, A., & Russo, P.(1994). Building learning communities for
new college students: A summary of research findings of the collaborative
learning project. University Park, PA: National Center on Post Secondary
Teaching, Learning, and Assessment.

Twigg, C. (1994). The Changing Definition of Learning. Education Review, 29(5).

Van Gelder, M. (1996). The strange case of the electronic lover. In R. Kung ( Ed.),
Computerization and Controversy. London: Academic Press.

Vygotsky, LS. (1978). In Cole, M., Seribner,S. and Souberman,E. (Eds), Minds in
Society. Cambridge, MA: Harvard University Press.

Wadden, T.A., Foster, G. D., &Letiza, K.A. (1994) One-year behavioral treatment of

87

obesity: Comparison of moderate and severe caloric restriction and the effects of
maintenance therapy. Journal of Consulting and Clinical Psychology, 62, 165-
1 71 .

Wadden, T.A.,& Strurkard, A.J. (2002). Handbook of Obesity Treatment. New York,
New York: The Guilfird Press.

Warf, B., Vincent, P., & Purcell, D. (1999). International collaborative learning on the
World Wide web. Journal of Geography, 98(3),]41-148.

Wilson, G. T., & Franks, C. M. (1982). Contemporary behavior therapy: Conceptual
foundations of clinical practice. New York, NY: Guilford Publishers.

Wing, R. R., Blair, E., Marcus, M. Epestein, L. H., & Harvey, J .(1994). Year-long weight
loss Treatment for obese patients with type-II diabetes: Does inclusion of

intermittent very low calorie diet improve outcome? American Journal of
Medicine, 97, 354-362.

Wing, RR. (1989). Behavioral strategies for weight reduction in obese type 11 diabetic
patients. Diabetes Care, 12, 139-144.

Yeok-Hwa, K.(1998) Enhancing student thinking through collaborative learning. US,
Indiana, Eric Clearinghouse Digest.

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