J Graham Thomas1,2, Emily Panza1,2, Hallie M Espel-Huynh1,2, Carly M Goldstein1,2, Kevin O'Leary1,2, Noah Benedict3, Albert J Puerini3,4, Rena R Wing1,2. 1. Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA. 2. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. 3. Rhode Island Primary Care Physicians Corporation, Cranston, Rhode Island, USA. 4. Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Abstract
OBJECTIVE: Behavioral obesity treatment implemented in primary care is efficacious but typically involves face-to-face or phone contact. This study evaluated enrollment, engagement, and 12-week weight loss in a fully automated online behavioral weight-loss intervention implemented pragmatically in a primary care network. METHODS: As part of routine primary care, providers and nurse care managers offered a no-cost online obesity treatment program to 1,721 patients. Of these, 721 consented and were eligible (aged 18-75 years with BMI ≥ 25 kg/m2 and internet access), and 464 started the program. The program included 12 weekly online lessons, a self-monitoring platform, and automated feedback. RESULTS: More than one-quarter of patients who were offered the program (26%) initiated treatment. In intent-to-treat analyses using all data available, mean 12-week weight change was -5.10% (SE = 0.21). Patients who submitted their weights on all 12 weeks (37% of 464) lost an estimated 7.2% body weight versus 3.4% in those submitting less frequently. CONCLUSIONS: This fully automated online program, implemented into the routine workflow of a primary care setting without any human counseling or researcher involvement, produced clinically meaningful short-term weight loss. Greater program engagement was associated with greater weight loss; efforts are needed to understand barriers to engagement.
OBJECTIVE: Behavioral obesity treatment implemented in primary care is efficacious but typically involves face-to-face or phone contact. This study evaluated enrollment, engagement, and 12-week weight loss in a fully automated online behavioral weight-loss intervention implemented pragmatically in a primary care network. METHODS: As part of routine primary care, providers and nurse care managers offered a no-cost online obesity treatment program to 1,721 patients. Of these, 721 consented and were eligible (aged 18-75 years with BMI ≥ 25 kg/m2 and internet access), and 464 started the program. The program included 12 weekly online lessons, a self-monitoring platform, and automated feedback. RESULTS: More than one-quarter of patients who were offered the program (26%) initiated treatment. In intent-to-treat analyses using all data available, mean 12-week weight change was -5.10% (SE = 0.21). Patients who submitted their weights on all 12 weeks (37% of 464) lost an estimated 7.2% body weight versus 3.4% in those submitting less frequently. CONCLUSIONS: This fully automated online program, implemented into the routine workflow of a primary care setting without any human counseling or researcher involvement, produced clinically meaningful short-term weight loss. Greater program engagement was associated with greater weight loss; efforts are needed to understand barriers to engagement.
Authors: Kevin E Thorpe; Merrick Zwarenstein; Andrew D Oxman; Shaun Treweek; Curt D Furberg; Douglas G Altman; Sean Tunis; Eduardo Bergel; Ian Harvey; David J Magid; Kalipso Chalkidou Journal: J Clin Epidemiol Date: 2009-05 Impact factor: 6.437
Authors: Tricia M Leahey; Graham Thomas; Joseph L Fava; Leslee L Subak; Michael Schembri; Katie Krupel; Rajiv Kumar; Brad Weinberg; Rena R Wing Journal: Am J Public Health Date: 2014-05-15 Impact factor: 9.308
Authors: Paul Little; Beth Stuart; Fd Richard Hobbs; Jo Kelly; Emily R Smith; Katherine J Bradbury; Stephanie Hughes; Peter W F Smith; Michael V Moore; Mike E J Lean; Barrie M Margetts; Chris D Byrne; Simon Griffin; Mina Davoudianfar; Julie Hooper; Guiqing Yao; Shihua Zhu; James Raftery; Lucy Yardley Journal: Lancet Diabetes Endocrinol Date: 2016-07-26 Impact factor: 32.069
Authors: Thomas A Wadden; Delia Smith West; Linda Delahanty; John Jakicic; Jack Rejeski; Don Williamson; Robert I Berkowitz; David E Kelley; Christine Tomchee; James O Hill; Shiriki Kumanyika Journal: Obesity (Silver Spring) Date: 2006-05 Impact factor: 5.002
Authors: Jun Ma; Veronica Yank; Lan Xiao; Philip W Lavori; Sandra R Wilson; Lisa G Rosas; Randall S Stafford Journal: JAMA Intern Med Date: 2013-01-28 Impact factor: 21.873
Authors: Mark A Espeland; W Jack Rejeski; Delia S West; George A Bray; Jeanne M Clark; Anne L Peters; Haiying Chen; Karen C Johnson; Edward S Horton; Helen P Hazuda Journal: J Am Geriatr Soc Date: 2013-05-13 Impact factor: 7.538