Behavioral Telehealth Applications in the Treatment of Obese Soldiers: A Feasibility Project and a Report on Preliminary Findings

James, Larry C.; Folen, Raymond A.; Earles, Jay Edward

doi:10.1207/s15327876mp1303_4

Cited by 11 publications

(18 citation statements)

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“…Nineteen studies were not randomized or quasi-randomized controlled trials and so we excluded them on the grounds of study design (Burnett 1984; Cange 2008; Collinson 2011; Cousineau 2008; Faghri 2008; Haugen 2007; James 2001; Joo 2010; Liou 2006; McHugh 2008; McTigue 2009; Nieto 2010; Park 2009; Petersen 2008; Riva 2000; Thurston 1991; Touger-Decker 2010; van der Mark 2009; Verheijden 2007). …”

Section: Resultsmentioning

confidence: 99%

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

Wieland

Falzon

Sciamanna

et al. 2012

Cochrane Database of Systematic Reviews

175

220

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Background The World Health Organization (WHO) estimates that the number of obese or overweight individuals worldwide will increase to 1.5 billion by 2015. Chronic diseases associated with overweight or obesity include diabetes, heart disease, hypertension and stroke. Objectives To assess the effects of interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. Search methods We searched several electronic databases, including CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO, through 25 May 2011. We also searched clinical trials registries to identify studies. We scanned reference lists of included studies and relevant systematic reviews. Selection criteria Studies were included if they were randomized controlled trials or quasi-randomized controlled trials that evaluated interactive computer-based weight loss or weight maintenance programs in adults with overweight or obesity. We excluded trials if the duration of the intervention was less than four weeks or the loss to follow-up was greater than 20% overall. Data collection and analysis Two authors independently extracted study data and assessed risk of bias. Where interventions, control conditions, outcomes and time frames were similar between studies, we combined study data using meta-analysis. Main results We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants. Treatment duration was between four weeks and 30 months. At six months, computer-based interventions led to greater weight loss than minimal interventions (mean difference (MD) −1.5 kg; 95% confidence interval (CI) −2.1 to −0.9; two trials) but less weight loss than in-person treatment (MD 2.1 kg; 95% CI 0.8 to 3.4; one trial). At six months, computer-based interventions were superior to a minimal control intervention in limiting weight regain (MD −0.7 kg; 95% CI −1.2 to −0.2; two trials), but not superior to infrequent in-person treatment (MD 0.5 kg; 95% −0.5 to 1.6; two trials). We did not observe consistent differences in dietary or physical activity behaviors between intervention and control groups in either weight loss or weight maintenance trials. Three weight loss studies estimated the costs of computer-based interventions compared to usual care, however two of the studies were 11 and 28 years old, and recent advances in technology render these estimates unlikely to be applicable to current or future interventions, while the third study was conducted in active duty military personnel, and it is unclear whether the costs are relevant to other settings. One weight loss study reported the cost-effectiveness ratio for a weekly in-person weight loss intervention relative to a computer-based intervention as USD 7177 (EUR 5678) per life year gained (80% CI USD 3055 to USD 60,291 (EUR 2417 to EUR 47,702)). It is unclear whether this could be extrapolated to other studies. No data were identified on adverse events, morbidity, complications or health-rel...

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Section: Resultsmentioning

confidence: 99%

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

Wieland

Falzon

Sciamanna

et al. 2012

Cochrane Database of Systematic Reviews

175

220

View full text Add to dashboard Cite

show abstract

“…The majority of papers (n = 9) reported an intervention based on cognitive behavioural theory (CBT; n = 8), or the transtheoretical model (TTM; n = 1). All interventions included PA as part of the treatment process; diet modification was offered by 9 of the interventions [23][24][25][26][27][28][29][30][31], with diet education incorporated into all but one [32]. With the exception of 3 interventions [26,32,33], self-monitoring techniques were generally included.…”

Section: Resultsmentioning

confidence: 99%

“…With the exception of 3 interventions [26,32,33], self-monitoring techniques were generally included. Behavioural or lifestyle change was a central topic in all but one of the interventions [32], whilst creating a supportive environment was only partially referred to in 8 of the interventions [23][24][25][26][27][28][29][30], each of which followed a 'cognitive-behavioural' approach. Significantly the intervention that used PA in isolation [32] was the least effective, achieving <1% weight loss.…”

Section: Resultsmentioning

confidence: 99%

The Correlates and Treatment of Obesity in Military Populations: A Systematic Review

Sanderson

Clemes

Biddle³

2011

Obes Facts

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Objective: The emergence of obesity as a distinct disease could have far reaching consequences for an organisation where optimum health and physical fitness are required for personnel to perform their occupational roles effectively. The objectives of this paper are to systematically review the literature concerning correlates and treatment of obesity in military populations. Methods: Through computerised searches of English language studies, 17 papers were identified (treatment (13), correlates (4)). Results: Successful treatment interventions incorporated exercise, healthy eating information, behavioural modification, self-monitoring, relapse prevention, and structured follow-up and were supported by trained personnel. Efficacy due to physical activity was underreported. Reduction in body fat rather than body weight was the most significant outcome. The major significant correlates of obesity were being enlisted personnel, male, ≧35 years of age, African-American/Hispanic ethnicity, and married (with spouse present). Conclusion: This systematic review highlights the deficit in knowledge concerning treatment and the lack of engagement in relation to the specific correlates of obesity in military populations.

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“…The majority of studies were conducted in the US [14, 17, 21–42], followed by Europe [43–54]. Ten studies included recruits during basic military training [21, 25, 43, 44, 47, 48, 50, 52, 55, 56], while 28 included fully qualified military personnel [14, 17, 22–24, 26–42, 45, 46, 49, 51, 53, 54]. Included studies were conducted in different military branches, including the Navy [14, 22, 26, 32], Air Force [17, 23, 30, 31, 34, 40–42], Army [33, 35–38, 49, 51, 53, 54], Defense Force [46], multiple military branches [24, 26–29] and military service/basic military training [21, 25, 43, 44, 47, 48, 50, 52, 55, 56].…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies included recruits during basic military training [21, 25, 43, 44, 47, 48, 50, 52, 55, 56], while 28 included fully qualified military personnel [14, 17, 22–24, 26–42, 45, 46, 49, 51, 53, 54]. Included studies were conducted in different military branches, including the Navy [14, 22, 26, 32], Air Force [17, 23, 30, 31, 34, 40–42], Army [33, 35–38, 49, 51, 53, 54], Defense Force [46], multiple military branches [24, 26–29] and military service/basic military training [21, 25, 43, 44, 47, 48, 50, 52, 55, 56]. Twelve studies were RCTs [14, 23, 25, 30, 32, 33, 35–37, 41, 51, 52], nine studies were nonrandomized control trials or quasi-experimental studies [17, 26, 31, 43, 44, 46, 47, 50, 52], 13 studies were longitudinal studies [21, 22, 24, 28, 38–40, 45, 48, 49, 54–56], and four studies were retrospective studies […”

Section: Resultsmentioning

confidence: 99%

Dietary, physical activity, and weight management interventions among active-duty military personnel: a systematic review

2018

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BackgroundResearch has been conducted to assess the effectiveness of weight management, dietary and physical activity interventions in military settings. However, a recent and comprehensive overview is lacking. The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition, dietary behaviors, and physical activity among active-duty military personnel.MethodsPubMed, PsycInfo, and CINAHL were searched on the 17th of November 2017 to identify interventions that promoted diet and/or physical activity among active-duty military personnel. Studies were included if they assessed outcomes related to anthropometric measurements, dietary behaviors, or fitness/physical activity levels. There were no restrictions regarding publication date, follow-up duration, and sex. After screening, a total of 136 studies were eligible. Of these studies, 38 included an educational and/or behavioral change component, and 98 had only physical or fitness training as part of basic military training. Only studies that included an educational and/or behavioral change component were assessed for quality using the Effective Public Health Practice Project tool and included in the qualitative synthesis of the results.ResultsBased on consistent evidence from studies that were rated as moderate or strong, there is good evidence that military weight management interventions are effective in improving body composition for durations of up to 12 months. Effective interventions are more likely to be high intensity (have a greater number of sessions), are more often delivered by specialists, and use theoretical base/behavioral change techniques and a standardized guideline. Dietary interventions can potentially reduce total fat and saturated fat intake. Dietary interventions that target the kitchen staff and/or increase the availability of healthy food are more likely to be effective in the short term. The results regarding military physical fitness interventions were inconclusive.ConclusionDespite limitations such as the diversity and heterogeneity of the included interventions, outcome measurements, and follow-up duration, this systematic review found good evidence that weight management interventions are effective, especially in terms of weight loss. More studies are needed to acquire solid evidence for effectiveness for durations longer than 12 months and to identify key components of the effective dietary and physical activity educational and/or behavioral change interventions, especially in countries outside Europe and the US.Electronic supplementary materialThe online version of this article (10.1186/s40779-018-0190-5) contains supplementary material, which is available to authorized users.

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Behavioral Telehealth Applications in the Treatment of Obese Soldiers: A Feasibility Project and a Report on Preliminary Findings

Cited by 11 publications

References 12 publications

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

The Correlates and Treatment of Obesity in Military Populations: A Systematic Review

Dietary, physical activity, and weight management interventions among active-duty military personnel: a systematic review

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