Perceived helpfulness of the individual components of a behavioural weight loss program: results from the Hopkins POWER Trial

A T Dalcin, G J Jerome, S L Fitzpatrick, T A Louis, N-Y Wang, W L Bennett, N Durkin, J M Clark, G L Daumit, L J Appel, J W Coughlin, A T Dalcin, G J Jerome, S L Fitzpatrick, T A Louis, N-Y Wang, W L Bennett, N Durkin, J M Clark, G L Daumit, L J Appel, J W Coughlin

Abstract

Background: Behavioural weight loss programs are effective first-line treatments for obesity and are recommended by the US Preventive Services Task Force. Gaining an understanding of intervention components that are found helpful by different demographic groups can improve tailoring of weight loss programs. This paper examined the perceived helpfulness of different weight loss program components.

Methods: Participants (n = 236) from the active intervention conditions of the Practice-based Opportunities for Weight Reduction (POWER) Hopkins Trial rated the helpfulness of 15 different components of a multicomponent behavioural weight loss program at 24-month follow-up. These ratings were examined in relation to demographic variables, treatment arm and weight loss success.

Results: The components most frequently identified as helpful were individual telephone sessions (88%), tracking weight online (81%) and coach review of tracking (81%). The component least frequently rated as helpful was the primary care providers' general involvement (50%). Groups such as older adults, Blacks and those with lower education levels more frequently reported intervention components as helpful compared with their counterparts.

Discussion: Weight loss coaching delivered telephonically with web support was well received. Findings support the use of remote behavioural interventions for a wide variety of individuals.

Keywords: Motivational Interviewing; perceived helpfulness; primary care; weight loss.

References

    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA 2014; 311: 806–814.
    1. Ogden C, Carroll M, Kit B, Flegal K. Prevalence of Obesity in the United States, 2009–2010. Vol 82 National Center for Health Statistics: Hyattsville, MD, 2012.
    1. Harvey JR, Ogden DE. Obesity treatment in disadvantaged population groups: where do we stand and what can we do? Prev Med 2014; 68: 71–75.
    1. Alpert MA, Lavie CJ, Agrawal H, Aggarwal KB, Kumar SA. Obesity and heart failure: epidemiology, pathophysiology, clinical manifestations, and management. Trans Res: J Lab Clin Med 2014; 164: 345–356.
    1. Apovian CM. The clinical and economic consequences of obesity. Am J Manag Care. 2013; 19(11 Suppl): s219–228.
    1. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014; 129(25 Suppl 2): S102–138.
    1. Butryn ML, Webb V, Wadden TA. Behavioral treatment of obesity. Psychiatr Clin North Am 2011; 34: 841–859.
    1. Wadden TA, Butryn ML, Wilson C. Lifestyle modification for the management of obesity. Gastroenterology 2007; 132: 2226–2238.
    1. Moyer VA, Force USPST. Screening for and management of obesity in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2012; 157: 373–378.
    1. Gilmore LA, Duhe AF, Frost EA, Redman LM. The technology boom: A new era in obesity management. J Diabetes Sci Technol 2014; 8: 596–608.
    1. Carter MC, Burley VJ, Nykjaer C, Cade JE. Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. J Med Internet Res 2013; 15: e32–e57.
    1. Booth AO, Nowson CA, Matters H. Evaluation of an interactive, Internet‐based weight loss program: a pilot study. Health Educ Res 2008; 23: 371–381.
    1. Khaylis A, Yiaslas T, Bergstrom J, Gore‐Felton C. A review of efficacious technology‐based weight‐loss interventions: five key components. Telemed J e‐health: Official J Am Telemed Assoc. 2010; 16: 931–938.
    1. Mehring M, Haag M, Linde K, et al. Effects of a general practice guided web‐based weight reduction program –results of a cluster‐randomized controlled trial. BMC Fam Pract 2013; 14: 76–85.
    1. Harvey‐Berino J, West D, Krukowski R, et al. Internet delivered behavioral obesity treatment. Prev Med 2010; 51: 123–128.
    1. Sherson EA, Yakes Jimenez E, Katalanos N. A review of the use of the 5 A's model for weight loss counselling: differences between physician practice and patient demand. Fam Pract 2014; 31: 389–398.
    1. Carvajal R, Wadden TA, Tsai AG, Peck K, Moran CH. Managing obesity in primary care practice: a narrative review. Ann N Y Acad Sci 2013; 1281: 191–206.
    1. Bennett WL, Gudzune KA, Appel LJ, Clark JM. Insights from the POWER practice‐based weight loss trial: a focus group study on the PCP's role in weight management. J Gen Intern Med 2014; 29: 50–58.
    1. Gudzune KA, Clark JM, Appel LJ, Bennett WL. Primary care providers' communication with patients during weight counseling: a focus group study. Patient Educ Couns 2012; 89: 152–157.
    1. Wadden TA, Butryn ML, Hong PS, Tsai AG. Behavioral treatment of obesity in patients encountered in primary care settings: a systematic review. JAMA 2014; 312: 1779–1791.
    1. Yoong SL, Carey M, Sanson‐Fisher R, Grady A. A systematic review of behavioural weight‐loss interventions involving primary‐care physicians in overweight and obese primary‐care patients (1999–2011). Public Health Nutr 2012; 16: 2083–2099.
    1. VanWormer JJ, Martinez AM, Cosentino D, Pronk NP. Satisfaction with a weight loss program: what matters? Am J Health Promot 2010; 24: 238–245.
    1. McConnon A, Kirk SF, Ransley JK. Process evaluation of an Internet‐based resource for weight control: use and views of an obese sample. J Nutr Educ Behav 2009; 41: 261–267.
    1. Barte JC, ter Bogt NC, Beltman FW, van der Meer K, Bemelmans WJ. Process evaluation of a lifestyle intervention in primary care: implementation issues and the participants' satisfaction of the GOAL study. Health Educ Behav: Official Public Soc Pub Health Educ 2012; 39: 564–573.
    1. Lakerveld J, Bot S, Chinapaw M, van Tulder M, Kingo L, Nijpels G. Process evaluation of a lifestyle intervention to prevent diabetes and cardiovascular diseases in primary care. Health Promot Pract 2012; 13: 696–706.
    1. Mattfeldt‐Beman M, Corrigan S, Stevens V, et al. Participant's evaluation of a weight‐loss program. J Am Diet Assoc 1999; 99: 66–71.
    1. Appel L, Clark J, Yeh H, et al. Comparative effectiveness of weight‐loss interventions in clinical practice. New England J Med 2011; 365: 1959–1986.
    1. van Wier MF, Ariens GA, Dekkers JC, et al. Phone and e‐mail counselling are effective for weight management in an overweight working population: a randomized controlled trial. BMC Public Health 2009; 9: 6–18.
    1. Sherwood NE, Jeffery RW, Pronk NP, et al. Mail and phone interventions for weight loss in a managed‐care setting: weigh‐to‐be 2‐year outcomes. Int J Obes (Lond) 2006; 30: 1565–1573.
    1. Wing RR, Papandonatos G, Fava JL, et al. Maintaining large weight losses: the role of behavioral and psychological factors. J Consult Clin Psychol 2008; 76: 1015–1021.
    1. Ruelaz AR, Diefenbach P, Simon B, et al. Perceived barriers to weight management in primary care – perspectives of patients and providers. J Gen Intern Med. 2007;22(4):518‐522.
    1. Lundahl B, Moleni T, Burke BL, et al. Motivational interviewing in medical care settings: a systematic review and meta‐analysis of randomized controlled trials. Patient Educ Couns. 2013; 93: 157–168.
    1. Mold JW, Fryer GE, Roberts AM. When do older patients change primary care physicians? J Am Board Fam Prac/Am Board Fam Pract 2004; 17: 453–460.
    1. Spring B, Duncan JM, Janke EA, et al. Integrating technology into standard weight loss treatment: a randomized controlled trial. JAMA Inter Med 2013; 173: 105–111.
    1. Levy RL, Finch EA, Crowell MD, Talley NJ, Jeffery RW. Behavioral intervention for the treatment of obesity: strategies and effectiveness data. Am J Gastroenterol. 2007; 102: 2314–2321.
    1. Martin KD, Roter DL, Beach MC, Carson KA, Cooper LA. Physician communication behaviors and trust among black and white patients with hypertension. Med Care 2013; 51: 151–157.
    1. Thande NK, Hurstak EE, Sciacca RE, Giardina EG. Management of obesity: a challenge for medical training and practice. Obesity 2009; 17: 107–113.
    1. McCoy MR, Couch D, Duncan ND, Lynch GS. Evaluating an internet weight loss program for diabetes prevention. Health Promot Int 2005; 20: 221–228.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj