Maintenance After Initiation of Nutrition TrAINing (MAINTAIN)

September 13, 2016 updated by: VA Office of Research and Development

Maintenance After Initiation of Nutrition TrAINing (MAINTAIN)

Obesity is the second leading cause of preventable deaths in the United States and is associated with a wide range of diseases. In people who are obese, weight loss improves blood pressure, dyslipidemia, glycemia, and arthritis symptoms; reduces medication use for several disease processes; increases physical functioning; and enhances health-related quality of life. The current study evaluated a theoretically informed maintenance intervention. If effective, this intervention could reduce the need for future clinic visits to treat obesity and its many associated illnesses.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Obesity is the second leading cause of preventable deaths in the United States and is associated with a wide range of diseases. In people who are obese, weight loss improves blood pressure, dyslipidemia, glycemia, and arthritis symptoms; reduces medication use for several disease processes; increases physical functioning; and enhances health-related quality of life. Despite these benefits, most patients who achieve weight loss regain much of this weight within a year, and few effective behavioral weight maintenance interventions have been identified. Thus, there is a dire need for effective interventions that can promote weight loss maintenance. Theoretical and empirical studies indicate that behavior maintenance is a distinct state that involves different psychological processes and behavioral skills than initial behavior change. The few trials that have tested weight loss maintenance interventions have not taken this distinction into account, which may partially explain their modest findings. The current study evaluated the efficacy of a theoretically informed maintenance intervention compared to usual care. If efficacious, this intervention could reduce the need for future clinic visits to treat obesity and its many associated illnesses and could serve as a model for redesigning the MOVE! program. This 3.5-year study involved a two-arm, randomized, controlled trial. During the run-in phase, Veterans with BMI 30 kg/m2 participated in a 4-month, intensive, group-based weight loss program. Participants who lost at least 4 kg by the end of 4 months (n=222) were randomized to receive (a) usual care (n=112) for 56 weeks or (b) a theoretically-informed maintenance intervention (n=110) for 42 weeks months, followed by 14 weeks of no intervention contact to examine sustainability. The maintenance intervention involved in-person group visits that transition to individualized telephone calls, and the frequency of contact with the interventionist gradually tapered over time. Outcomes were assessed at randomization and at weeks 14, 26, 42, and 56 post-randomization. The hypotheses are that the maintenance intervention will result in at least 3.5 kg greater weight loss and greater improvements in caloric intake and physical activity over the study period, and that it will be cost-effective, compared to usual care.

Study Type

Interventional

Enrollment (Actual)

222

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • North Carolina
      • Durham, North Carolina, United States, 27705
        • Durham VA Medical Center, Durham, NC

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 74 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • BMI >= 30 kg/m2
  • Desire to lose weight
  • Agrees to attend regular visits per study protocol
  • Has a provider at the Durham Veterans Affairs Medical Center

Exclusion Criteria:

  • Age >= 75 years old,
  • Most recent serum creatinine >2.0 mg/dL in men, >1.7 mg/dL in women),
  • Liver disease (cirrhosis, jaundice, or other stigmata of advanced liver disease),
  • Type 1 diabetes,
  • Hemoglobin A1c >= 12% in past 6 months
  • unstable angina or coronary ischemia workup in past 3 months
  • Female: pregnancy, breastfeeding, or lack of birth control if premenopausal
  • Transplant recipient
  • Pacemaker or defibrillator (bioelectric impedance assessment might interfere with these)
  • Average systolic blood pressure in the past year >= 160 mmHg AND most recent BP >=160 mmHg
  • Dementia, severe psychiatric illness (e.g., major depression), alcohol problem, or illicit substance abuse
  • Weight loss of at least 10 lb in previous 3 months
  • Enrollment in a weight loss program
  • Unable to stand for study measurements
  • history of weight loss surgery
  • cancer not in remission
  • current use of appetite suppressants or weight loss medication
  • lack of reliable transportation or telephone

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Maintenance intervention
Participants receive a theoretically-informed maintenance intervention for 42 weeks, followed by 14 weeks of no intervention contact to examine sustainability. The maintenance intervention involves in-person group visits that transition to individualized telephone calls, and the frequency of contact gradually decreases over time.
Behavioral: Maintenance intervention
Theoretically-informed maintenance intervention that involves in-person group visits that transition to individualized telephone calls, and the frequency of contact gradually decreases over time.
No Intervention: Usual care
Participants receive usual care for 56 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Weight
Time Frame: 56 weeks post-randomization
56 weeks post-randomization

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Estimated Daily Caloric Intake
Time Frame: 56 weeks
Based on self-report using Block Brief Food Frequency Questionnaire
56 weeks
Estimated Metabolic Minutes of Walking Per Week
Time Frame: 56 weeks
self-reported based on short form of International Physical Activity Questionnaire
56 weeks
Estimated Metabolic Minutes of Moderate Physical Activity Per Week
Time Frame: 56 weeks
self-reported based on short form of International Physical Activity Questionnaire
56 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

VA Office of Research and Development

Investigators

  • Principal Investigator: Corrine I Voils, PhD, Durham VA Medical Center, Durham, NC

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2012

Primary Completion (Actual)

November 1, 2015

Study Completion (Actual)

November 1, 2015

Study Registration Dates

First Submitted

May 13, 2011

First Submitted That Met QC Criteria

May 18, 2011

First Posted (Estimate)

May 20, 2011

Study Record Updates

Last Update Posted (Estimate)

November 2, 2016

Last Update Submitted That Met QC Criteria

September 13, 2016

Last Verified

September 1, 2016

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IIR 11-040

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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