Online Counseling to Enable Lifestyle-focused Obesity Treatment in Primary Care

2014-08-27 03:16:52 | BioPortfolio


With over half of the US population currently overweight and 31% of adults now obese, the primary care setting may represent an important source of weight-loss support, in the interest of cardiovascular prevention. Yet, although the US Preventive Services task force recommends that physicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults, the recommendation has not been widely implemented The Internet may help overcome many of the barriers that have prevented intensive obesity counseling in the clinical setting. The aim of this study is to examine whether Internet-based interventions for developing healthier lifestyles can improve preventive health care in a cost-effective manner.


The study, Online counseling to enable lifestyle-focused obesity treatment in primary care, aims to translate an evidence-based lifestyle intervention into the primary care setting, using information technology to enable clinical lifestyle counseling. While the US Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults, multiple barriers to intensive lifestyle counseling exist and the recommendation has not been widely implemented. We propose to examine two coaching strategies for delivering an online version of a comprehensive intervention combining diet and exercise advice with behavioral tools. This intervention, originally developed for the Diabetes Prevention Program (DPP), is consistent with the counseling approach recommended by the USPSTF and has proven efficacy for promoting weight loss. We will randomize patients to one of three study arms, comparing the effect of the two online coaching strategies for delivering the Internet-based DPP intervention with a third arm in which patients are provided specific lifestyle goals and online links to community resources that support lifestyle change. By requiring physician referral, augmenting the health care team's access to behavioral expertise, and encouraging physician feedback to participating patients, we aim to integrate lifestyle issues into routine preventive medicine. In the arms based on the DPP intervention, an Internet-based approach allows us to combine intensive evidence-based counseling with relatively low staffing needs and extraordinary flexibility in terms of patients scheduling and location preferences. We will examine change in weight, waist circumference, physical activity, quality of life, and will calculate intervention cost-effectiveness. We will ensure sustainability by using recruitment and adherence strategies that can be replicated in routine practice, and counseling staff who are representative of the educators employed in primary care practice. If an online strategy is effective, the extensive network of the University of Pittsburgh Medical Center Health System provides excellent infrastructure for supporting dissemination in the region. As such, this study may facilitate wide-spread adoption of current evidence-based preventive medicine guidelines recommending incorporation of intensive lifestyle interventions into primary care practice.

Study Design

Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment




VLM Intervention with Scheduled Coaching, VLM Intervention with Modulated Coaching, Online lifestyle Goals and Resources


University of Pittsburgh
United States




University of Pittsburgh

Results (where available)

View Results


Published on BioPortfolio: 2014-08-27T03:16:52-0400

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Medical and Biotech [MESH] Definitions

Intervention that relies on free expression of emotions with coaching to enhance awareness of emotional experiences.

A study in which observations are made before and after an intervention, both in a group that receives the intervention and in a control group that does not.

A study that uses observations at multiple time points before and after an intervention (the "interruption"), in an attempt to detect whether the intervention has had an effect significantly greater than any underlying trend over time.

Skills and strategies, unrelated to the traits a test is intended to measure, that may increase test takers' scores -- may include the effects of coaching or experience in taking tests. (ERIC Thesaurus)

Procedures and programs that facilitate the development or skill acquisition in infants and young children who have disabilities, who are at risk for developing disabilities, or who are gifted. It includes programs that are designed to prevent handicapping conditions in infants and young children and family-centered programs designed to affect the functioning of infants and children with special needs. (From Journal of Early Intervention, Editorial, 1989, vol. 13, no. 1, p. 3; A Discursive Dictionary of Health Care, prepared for the U.S. House of Representatives Committee on Interstate and Foreign Commerce, 1976)

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