Two‐Year Results of Think Health! ¡Vive Saludable!: A Primary Care Weight‐Management Trial |
| |
| Authors: | Shiriki K Kumanyika Knashawn H Morales Kelly C Allison A Russell Localio David B Sarwer Etienne Phipps Jennifer E Fassbender Adam G Tsai Thomas A Wadden |
| |
| Affiliation: | 1. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA;2. Center for Weight and Eating Disorders, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA;3. Center for Obesity Research and Education, Temple University College of Public Health, Philadelphia, Pennsylvania, USA;4. Center for Urban Health Policy and Research, Albert Einstein Healthcare Network, Philadelphia, Pennsylvania, USA;5. Public health consultant, Philadelphia, Pennsylvania, USA;6. Reinvestment Fund, Philadelphia, Pennsylvania, USA;7. Kaiser Permanente, Denver, Colorado, USA |
| |
| Abstract: | Objective Think Health! ¡Vive Saludable! evaluated a moderate‐intensity, lifestyle behavior‐change weight‐loss program in primary care over 2 years of treatment. Final analyses examined weight‐change trajectories by treatment group and attendance. Methods Adult primary care patients (n = 261; 84% female; 65% black; 16% Hispanic) were randomly assigned to Basic Plus (moderate intensity; counseling by primary care clinician and a lifestyle coach) or Basic (clinician counseling only). Intention‐to‐treat analyses used all available weight measurements from data collection, treatment, and routine clinical visits. Linear mixed‐effects regression models adjusted for treatment site, gender, and age, and sensitivity analyses evaluated treatment attendance and the impact of loss to follow‐up. Results Model‐based estimates for 24‐month mean (95% CI) weight change from baseline were ?1.34 kg (?2.92 to 0.24) in Basic Plus and ?1.16 kg (?2.70 to 0.37) in Basic (net difference ?0.18 kg ?2.38 to 2.03]; P = 0.874). Larger initial weight loss in Basic Plus was attenuated by a ~0.5‐kg rebound at 12 to 16 months. Each additional coaching visit was associated with a 0.37‐kg greater estimated 24‐month weight loss (P = 0.01). Conclusions These findings in mostly black and Hispanic female primary care patients suggest that strategies to improve treatment attendance may improve weight loss resulting from moderate‐intensity counseling. |
| |
| Keywords: | |
|
|
