Abstract P119: Tailored Lifestyle Intervention for Obese, Sedentary Patients in Primary Care: Choose to Lose Study
Background: Poor diet and lack of physical activity are linked conditions, both are risk factors for obesity and cardiovascular disease and prevalent in primary care. Studies of how to accomplish effective changes in physical activity and weight loss simultaneously in obese, sedentary patients in primary care are limited. In this report we present the findings of the physical activity intervention.
Methods: We conducted a randomized, controlled translational research trial of behavioral Interventions in 207 obese, sedentary patients recruited from 24 primary care practices. Participants were 79% women, 17% minority, with a mean age of 48.8 years, and 66% had at least one CVD risk factor. The primary care physicians identified obese , sedentary patients motivated to lose weight and increase physical activity , who were then randomized to one of two experimental groups ( enhanced or standard). Both groups received 3 face-to-face visits with a lifestyle counselor(baseline, 6 months and 12 months) that included physical activity goal setting and exercise log tracking. The enhanced intervention also received frequent mailings related to diet and exercise, monthly tailored mailings using an expert system related to the transtheoretical model of change for physical activity, 2 DVDs related to exercise and monthly phone calls by lifestyle counselors for the first 12 months related to diet and exercise . A maintenance phase with twice monthly mailings for 6 months and then monthly occurred for the last 6 months. The trial was 24 months in duration with follow-up research visits at 6, 12, 18 and 24 months. Statistical analysis used a mixed model adjusted for age, gender, and race accounting for clustering within primary care practice site.
Results: The minutes of moderate and vigorous physical activity(MVPA) per week for the enhanced intervention group were 20.7, 95.7, 126.1, 103.7, 101.3 at baseline, 6,12, 18 and 24 months compared to 22.9, 68.3, 73.7, 63.7, 75.4 for the standard intervention group ( p=0.037 group*visit). Compared to baseline both groups increased physical activity at each time point ( p<.001). Comparing enhanced to standard interventions at each time point showed increased physical activity for the enhanced group at 12 months and 18 months, but by 24 months the differences were no longer statistically significant ( p=.10)
Conclusion: A lifestyle intervention increased physical activity over 24 months in primary care practice in motivated obese, sedentary adults . The added benefits of a tailored approach using an expert system, appear to limited to 12 and 18 months of intervention. Much less contact was provided between 18-24 months. Future research should focus on the optimal dose of the intervention to maintain increased physical activity.
Author Disclosures: C.B. Eaton: None. S. Hartman: None. P.M. Risica: None. K.M. Gans: None. B.H. Marcus: None.
- © 2015 by American Heart Association, Inc.