Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes

Abstract

OBJECTIVE:To describe methods, recruitment success, and 1-y results of a study evaluating the effectiveness of phone-and mail-based weight-loss interventions in a managed care setting. DESIGN: Randomized clinical trial with three groups, that is, usual care, mail intervention, and phone intervention. SUBJECTS: In total, 1801 overweight members of a managed-care organization (MCO). MEASUREMENTS: Height, weight, medical status, and weight-loss history were measured at baseline. Participation in intervention activities was monitored for 12 months in the two active treatment groups. Self-reported weight was obtained at 6 and 12 months. RESULTS: More individuals assigned to mail treatment started it (88%) than did those assigned to phone treatment (69%). However, program completion rates were higher in the phone (36%) than mail (7%) intervention. The mean weight losses were 1.93, 2.38, and 1.47 kg at 6 months in the mail, phone, and usual care groups, respectively. The differences between the phone and usual care groups were statistically significant. The mean weight losses at 12 months did not differ by treatment group (2.28 kg mail, 2.29 kg phone, and 1.92 kg usual care). Greater weight loss was seen in men, older participants, and those with no prior experience in a weight-loss program. Heavier participants and those who reported current treatment for depression lost less weight. CONCLUSION: Although mail-and phone-based weight-loss programs can be delivered to large numbers of people in an MCO setting, additional work is needed to enhance their clinical efficacy as well as to assess their costs.

The comparative and cumulative effects of a dietary restriction and exercise on weight loss

“…Details of the study design are reported elsewhere. 29 All participants were volunteers 18 years or older with a BMI index greater than 27.0 kg/m 2 , based on reported height and weight.…”

Effect of web-based lifestyle modification on weight control: a meta-analysis

“…46 Actually, several studies have reported that compliance or levels of Internet usage were found to be associated with weight loss. 10,20,23,32,[47][48] However, quite a few of the studies included in this meta-analysis did not provide information on compliance (for example, Website log-in frequency). Fourth, few studies have been conducted on Web-based weight-loss programs targeted exclusively for men, partly because of the fact that men are less interested in weight loss than women.…”

Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project

“…Men comprised 36% of participants in 18 of the trials (4771 from a total of 13,305 participants); in four trials numbers of men recruited were unclear [23][24][25][26]. Eleven trials [23,[26][27][28][29][30][31][32][33][34][35] were conducted in the USA; six [24,25,[36][37][38][39] in Finland and one trial from each of the following locations: Canada [40], Israel [41], Scandinavia [42], Sweden [43,43]and the UK [44].…”

“…Two trials [38,44] considered different types of weight loss service provider. The remaining trials considered spouse involvement [26], modification of the home environment [28], telephone or mail contact [30], and varying monetary contracts [29].…”

“…Jeffery and colleagues [30] compared the effectiveness of an intervention including weight reduction, physical activity advice and behaviour change techniques delivered via telephone or mail. A control group received usual care.…”