Weight management in rural health clinics: The Midwest diet and exercise trial

Gorczyca, Anna M.; Washburn, Richard A.; Ptomey, Lauren T.; Mayo, Matthew S.; Sullivan, Debra K.; Gibson, Cheryl; Lee, Robert; Stolte, Sarah; Donnelly, Joseph E.

doi:10.1016/j.cct.2018.02.006

Cited by 4 publications

(4 citation statements)

References 74 publications

(89 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Strengths of this trial include the use of a randomized design, intervention delivery of all three intervention arms by the same interventionist to reduce the potential of interventionist effects, a high level of fidelity for intervention delivery, and reasonable participant compliance with the dietary and self‐monitoring components of the intervention. The COVID‐19 pandemic, which resulted in participant retention of <51% at 12, 18 and 24 months, is the primary weakness of this trial and eliminated our ability to conduct a statistical comparison of weight change between intervention arms following both a weight maintenance intervention and a 6‐months no‐contact follow‐up as proposed 20 . This trial provided no‐cost, low‐calorie shakes (2/day) across the 6‐month weight loss intervention, which may have impacted the adherence with dietary recommendations and the magnitude of weight loss observed in this trial.…”

Section: Discussionmentioning

confidence: 99%

“…The COVID‐19 pandemic, which resulted in participant retention of <51% at 12, 18 and 24 months, is the primary weakness of this trial and eliminated our ability to conduct a statistical comparison of weight change between intervention arms following both a weight maintenance intervention and a 6‐months no‐contact follow‐up as proposed. 20 This trial provided no‐cost, low‐calorie shakes (2/day) across the 6‐month weight loss intervention, which may have impacted the adherence with dietary recommendations and the magnitude of weight loss observed in this trial. However, low‐calorie shakes similar to those used in this trial are widely available at grocery stores and on‐line at a cost of ∼$1.25 each, which should not impose an unrealistic financial burden for rural living adults seeking weight management.…”

Section: Discussionmentioning

confidence: 99%

“…A detailed description of the rationale, design, and methods for this trial has been previously published 20 . Briefly, we randomized 187 adults with overweight/obesity in a ∼2:2:1 allocation to the GP ( n = 71), IP ( n = 80), or EUC ( n = 36) arms.…”

Section: Methodsmentioning

confidence: 99%

“…A detailed description of the rationale, design, and methods for this trial has been previously published. 20 Briefly, we randomized 187 adults with overweight/obesity in a ∼2:2:1 allocation to the GP ( n = 71), IP ( n = 80), or EUC ( n = 36) arms. The trial was designed and powered to compare 6‐month weight loss (kg) between the GP and IP arms and between the IP and EUC arms using intention‐to‐treat (ITT) principles.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Weight management in rural health clinics: Results from the randomized midwest diet and exercise trial

Gorczyca,

Washburn,

Ptomey

et al. 2024

Obesity Science & Practice

Self Cite

View full text Add to dashboard Cite

IntroductionRural living adults have higher rates of obesity compared with their urban counterparts and less access to weight management programs. Previous research studies have demonstrated clinically relevant weight loss in rural living adults who complete weight management programs delivered by university affiliated interventionists. However, this approach limits the potential reach, adoption, implementation, and maintenance of weight management programs for rural residents. Weight management delivered through rural health clinics by non‐physician clinic associated staff, for example, nurses, registered dieticians, allied health professionals, etc. has the potential to improve access to weight management for rural living adults. This trial compared the effectiveness of a 6‐month multicomponent weight management intervention for rural living adults delivered using group phone calls (GP), individual phone calls (IP) or an enhanced usual care control (EUC) by rural clinic associated staff trained by our research team.MethodsRural living adults with overweight/obesity (n = 187, age ∼ 50 years 82% female, body mass index ∼35 kg/m2) were randomized (2:2:1) to 1 of 3 intervention arms: GP, which included weekly ∼ 45 min sessions with 7–14 participants (n = 71), IP, which included weekly ∼ 15 min individual sessions (n = 80), or EUC, which included one‐45 min in‐person session at baseline.ResultsWeight loss at 6 months was clinically relevant, that is, ≥5% in the GP (−11.4 kg, 11.7%) and the IP arms (−9.1 kg, 9.2%) but not in the EUC arm (−2.6%, −2.5% kg). Specifically, 6 month weight loss was significantly greater in the IP versus EUC arms (−6.5 kg. p ≤ 0.025) but did not differ between the GP and IP arms (−2.4 kg, p > 0.025). The per participant cost per kg. weight loss for implementing the intervention was $93 and $60 for the IP and GP arms, respectively.ConclusionsWeight management delivered by interventionists associated with rural health clinics using both group and IP calls results in clinically relevant 6 months weight loss in rural dwelling adults with overweight/obesity with the group format offering the most cost‐effective strategy.Clinical trial registration: ClinicalTrials.gov (NCT02932748).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations