Extended-Care Programs for Weight Management in Rural Communities

Perri, Michael G.; Limacher, Marian C.; Durning, P; Janicke, David M.; Lutes, Lesley D.; Bobroff, Linda B.; Dale, Martha Sue; Daniels, Michael J.; Radcliff, Tiffany A.; Martin, A. Daniel

doi:10.1001/archinte.168.21.2347

Cited by 233 publications

(178 citation statements)

References 40 publications

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“…Attendance was modest (i.e., 40–50%), which was similar to or slightly lower than attendance rates observed with other applied weight management programs. 16–17, 21, 29 …”

Section: Discussionmentioning

confidence: 99%

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

et al. 2015

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Purpose The purpose of this single-group pilot study was to evaluate the feasibility, acceptability, and initial outcomes of a novel approach to delivering weight loss treatment in primary care using peer coaches and targeting predominantly African American patients with diabetes or pre-diabetes. Methods Participants (N=33) were recruited from a family medicine practice for a 6-month lifestyle intervention. Eligible patients were obese adults (body mass index; BMI ≥30 kg/m2) with ≥1 additional cardio-metabolic risk factor(s), including 1) elevated hemoglobin A1C or diagnosed diabetes, 2) elevated blood pressure, 3) elevated triglycerides, and/or 4) low HDL. The intervention included a combination of 12 group-based office visits with health professionals plus 12 individual phone contacts with peer coaches. Outcomes included weight loss, program adherence, and program satisfaction. Results Participants (mean age = 56±10 years; BMI=42.9±11.0 kg/m2) were predominantly female (88%) and African American (85%). Treatment resulted in a significant mean weight loss of −4.5±7.2 kg, and approximately 27% of participants lost ≥5% of their initial body weight. Participants completed approximately 50% of the group visits and 40% of the telephone calls with peer coaches. Participants rated both components of the intervention favorably. Conclusions Results of this pilot study indicated that a primary care weight management program including group-based visits and peer-delivered telephone contacts achieved significant weight loss among predominantly African-American patients with weight-related comorbidities, including diabetes and pre-diabetes. Additional research is needed to examine the long-term outcomes of this novel approach and to identify program components supporting patients’ success.

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“…Attendance was modest (i.e., 40–50%), which was similar to or slightly lower than attendance rates observed with other applied weight management programs. 16–17, 21, 29 …”

Section: Discussionmentioning

confidence: 99%

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

et al. 2015

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“…Previous studies that have had success with WLM have had longer-term interventions and support. 22,38,104 The trial comprised three arms: (1) an intensive intervention arm, (2) a less intensive intervention arm and (3) a control arm. We hypothesised that the intensive intervention would be effective and that the less intensive intervention would have an effect somewhere between the control and intensive intervention.…”

Section: The Weight Loss Maintenance In Adults Trial Interventionmentioning

confidence: 99%

A feasibility randomised controlled trial of a motivational interviewing-based intervention for weight loss maintenance in adults

Simpson

McNamara

Shaw

et al. 2015

Health Technol Assess

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This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 08/44/04. The contractual start date was in September 2010. The draft report began editorial review in April 2014 and was accepted for publication in September 2014. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HTA programme or the Department of Health. Published by...

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“…For example, findings from the TOURS (Treatment of Obesity in Underserved Rural Settings) Trial (12) showed promising findings for a long-term, lifestyle intervention delivered through Extension offices in rural counties. However, the high dose of treatment in the TOURS Trial (i.e., 50 sessions over 18 months) poses a significant obstacle to implementation in rural communities.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of three doses of weight-loss counseling: Two-year findings from the rural LITE trial

Perri

Limacher

Castel-Roberts

et al. 2014

Obesity

Self Cite

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ObjectiveTo evaluate the effects and costs of three doses of behavioral weight-loss treatment delivered via Cooperative Extension Offices in rural communities.Design and MethodsObese adults (N=612) were randomly assigned to low, moderate or high doses of behavioral treatment (i.e., 16, 32 or 48 sessions over two years) or to a control condition that received nutrition education without instruction in behavior modification strategies.ResultsTwo-year mean reductions in initial body weight were 2.9% (95% Credible Interval=1.7–4.3), 3.5% (2.0–4.8), 6.7% (5.3–7.9), and 6.8% (5.5–8.1) for the control, low, moderate, and high-dose conditions, respectively. The moderate-dose treatment produced weight losses similar to the high-dose condition and significantly larger than the low-dose and control conditions (posterior probability > .996). The percentages of participants who achieved weight reductions ≥ 5% at two years were significantly higher in the moderate-dose (58%) and high-dose (58%) conditions compared with low-dose (43%) and control (40%) conditions (posterior probability > .996). Cost-effectiveness analyses favored the moderate-dose treatment over all other conditions.ConclusionA moderate dose of behavioral treatment produced two-year weight reductions comparable to high-dose treatment but at a lower cost. These findings have important policy implications for the dissemination of weight-loss interventions into communities with limited resources.Trial RegistrationClinicalTrials.gov number, NCT00912652.

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Extended-Care Programs for Weight Management in Rural Communities

Cited by 233 publications

References 40 publications

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

Pilot Study Evaluating the Feasibility and Initial Outcomes of a Primary Care Weight Loss Intervention With Peer Coaches

A feasibility randomised controlled trial of a motivational interviewing-based intervention for weight loss maintenance in adults

Comparative effectiveness of three doses of weight-loss counseling: Two-year findings from the rural LITE trial

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