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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

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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.

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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.

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Authors and Affiliations

  1. University of Canberra Research Institute for Sport and Exercise, Canberra, Australia

    Emily Lewis, Peter Hassmén, Marijke Welvaert & Kate L. Pumpa

  2. Canberra Health Services, Division of Medicine, Chronic Disease Management Unit, Obesity Management Service, Canberra, Australia

    Emily Lewis & Hsin-Chia Carol Huang

  3. Medical School, College of Health and Medicine, Australian National University, Canberra, Australia

    Hsin-Chia Carol Huang

  4. School of Health and Human Sciences, Southern Cross University, Lismore, Australia

    Peter Hassmén

  5. Innovation, Research and Development, Australian Institute of Sport, Canberra, Australia

    Marijke Welvaert

  6. Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia

    Kate L. Pumpa

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  1. Emily Lewis
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Correspondence to Emily Lewis.

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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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Lewis, E., Huang, HC.C., Hassmén, P. et al. Adding Telephone and Text Support to an Obesity Management Program Improves Behavioral Adherence and Clinical Outcomes. A Randomized Controlled Crossover Trial. Int.J. Behav. Med. 26, 580–590 (2019). https://doi.org/10.1007/s12529-019-09815-1

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