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Adding Telephone and Text Support to an Obesity Management Program Improves Behavioral Adherence and Clinical Outcomes. A Randomized Controlled Crossover Trial

  • Emily LewisEmail author
  • Hsin-Chia Carol Huang
  • Peter Hassmén
  • Marijke Welvaert
  • Kate L. Pumpa
Full length manuscript
  • 16 Downloads

Abstract

Background

Behavioral treatment strategies improve adherence to lifestyle intervention for adults with obesity, but can be time and resource intensive when delivered via traditional face-to-face care. This study aimed to investigate the efficacy and optimal timing of using telephone calls and text message as adjunctive tools to support a community-based obesity management program.

Method

This 8-month randomized controlled crossover trial recruited 61 adults with class III obesity (BMI > 40 kg/m2) enrolled in a publicly funded obesity management service (OMS). Participants were randomly assigned to receive telephone and text message support in addition to standard OMS care, or standard OMS care alone. After 4 months, participants crossed over to the alternative sequence. The technological support was based on self-determination theory. Outcome measures included diet, physical activity, anthropometry, self-efficacy, and treatment self-regulation.

Results

Telephone and text message support improved lifestyle intervention adherence and clinical outcomes when compared with standard care. Participants who received the intervention in the first 4-month period lost 4.87 kg, compared with no weight loss (+ 0.38 kg) in the standard care only group. There was no evidence to indicate an optimal timing of the intervention, with both groups achieving significant results by the end of the intervention.

Conclusion

These results suggest a high degree of promise for the incorporation of telephone and text message support into community-based obesity management services. The findings have the potential to improve existing practices and reduce the burden on the health care system by demonstrating a resource-effective improvement to obesity management service delivery.

Keywords

Obesity Behavioral treatment Technology Text message Telephone mHealth Telehealth Adherence Compliance Weight loss 

Notes

Acknowledgments

Thank you to all of the participants who gave up their time to participate in this study; your support of this important research is greatly appreciated.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© International Society of Behavioral Medicine 2019

Authors and Affiliations

  1. 1.University of Canberra Research Institute for Sport and ExerciseCanberraAustralia
  2. 2.Canberra Health Services, Division of Medicine, Chronic Disease Management Unit, Obesity Management ServiceCanberraAustralia
  3. 3.Medical School, College of Health and MedicineAustralian National UniversityCanberraAustralia
  4. 4.School of Health and Human SciencesSouthern Cross UniversityLismoreAustralia
  5. 5.Innovation, Research and DevelopmentAustralian Institute of SportCanberraAustralia
  6. 6.Discipline of Sport and Exercise Science, Faculty of HealthUniversity of CanberraCanberraAustralia

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