POWER Hopkins at Johns Hopkins University recruited participants from six primary care practices in the Baltimore area. Participants were randomized to one of the three arms.
Those assigned to the self-directed control condition received written materials, as well as ongoing access to a static web page.
Participants assigned to the Remote Support Only condition received a multi-channel, behavioral intervention with telephone, web, and email contacts, without in-person visits, implemented by trained coaches of Healthways, a disease management company.
Those assigned to the In-Person Support condition received a multi-channel behavioral intervention with in-person, group and individual sessions, along with telephone, web, and email contacts.
The In-Person Support condition was delivered by coaches at the Hopkins clinical center.
Both active interventions used established behavioral techniques to achieve weight loss (i.e., frequent contact, self-monitoring of weight and physical activity, use of food records, accountability), and a web-based hub to facilitate communication among counselors, participants, and the primary care provider (PCP), as well as to promote behavior change in participants.
At Hopkins, PCPs had a supportive, rather than a primary role, in delivering the interventions.
At routinely scheduled visits, the PCP reviewed participants' weight loss reports and encouraged participants in the Remote and In-Person support conditions to remain active in the weight loss program.
Appel, LJ., Clark, JM., Yeh, HC, Wang, NY, Coughlin, JW, Daumit, G, Miller, ER, Dalcin, A, Jerome, GJ, Geller, S, Noronha, G, Pozefsky, T, Charleston, Reynolds, JB, Durking, N, Rubin, RR, Louise, TA, Brancati, FL (2011). Comparative Effectiveness if Weight-Loss Interventions in Clinical Practice. New England Journal of Medicine. 365(20). doi: 10.1056/NEJMoa1108660 [link]
"Best Published Research Paper of the Year" - Society of General Internal Medicine 2011
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