Gary G. Bennett|Dori Steinberg|Sandy Askew|Erica Levine|Perry Foley|Bryan C. Batch|Laura P. Svetkey|Hayden B. Bosworth|Elaine Puleo|Ashley Brewer|Abigail DeVries|Heather Miranda
Effectiveness of an App and Provider Counseling for Obesity Treatment in Primary Care
Duke University|Duke Institute for Health Innovation|Duke Institute for Health Innovation|Duke Institute for Health Innovation|Duke Institute for Health Innovation|Duke Institute for Health Innovation|Duke University|Duke University Hospital|Duke Medical Center|Duke University|Duke University Hospital|Duke Medical Center|University of Massachusetts Amherst|Piedmont HealthCare|Piedmont HealthCare|Wake County Human Services
obesity treatment less successful socioeconomically disadvantaged populations particularly delivered primary care digital health strategies extend reach clinical obesity treatments care settings serving patients highest risktrack effectiveness rct 12month digital weightloss intervention embedded within community health center system participants 351 adult patients aged 2165 years obesity hypertension diabetes hyperlipidemia patients randomized usual care n175 intervention n176 comprising appbased selfmonitoring behavior change goals tailored feedback smart scale dietitiandelivered counseling calls clinician counseling informed appgenerated recommendations delivered via electronic health record primary outcome 12month weight change randomization began june 18 2013 final assessments completed september 10 2015 data analysis conducted 2016 2017 trial retained 92 usual care 96 intervention participants 12 monthsthe track intervention produced larger weight losses relative usual care 6 months net effect 44 kg 95 ci 55 33 p0001 12 months net effect 38 kg 95 ci 50 25 p0001 intervention participants likely lose 5 baseline weight 6 months 43 vs 6 p0001 12 months 40 vs 17 p0001 intervention participants completing 80 expected selfmonitoring episodes 35 kg counseling calls 30 kg selfweighing days 44 kg lost significantly weight less engaged intervention participants p001a digital obesity treatment integrated health system resources produce clinically meaningful weightloss outcomes among socioeconomically disadvantaged primary care patients elevated cardiovascular disease riskthis study registered wwwclinicaltrialsgov nct01827800