Outcomes of an RCT of video‐conference vs. in‐person or in‐clinic nutrition and exercise in midlife adults with obesity

Abstract

Objective New communication technologies have shown some promise in lifestyle weight loss interventions, but may be most effective when leveraging face‐to‐face communications. The study reported here sought to test whether weight loss program attendance and outcomes are greater when offered in‐person at community sites or remotely via videoconference versus in federally qualified health centers (FHQCs). In a three‐arm randomized trial among 150 FQHC adults, intervention delivery in community‐sites or via videoconference were tested against a clinic‐based lifestyle intervention (enhanced usual care [EUC]). Methods Twice weekly, a nutrition topic was reviewed, and exercise sessions were held in a 20‐week program delivered either in community settings or via videoconference. The primary outcome was the proportion of participants losing more than 2 kg at 6 (end of treatment) and 12 months in intent‐to‐treat analyses. Results Mean (SD) age was 53 (7) years, 82% were female, 65% were African‐American, 50% reported $18,000 or less household income, 49% tested low in health literacy, and mean (SD) body mass index was 39 (6) kg/m2. The proportion losing more than 2 kg of weight in the community site, videoconference, and EUC groups was 33%, 34%, and 24%, respectively at 6 months, and 29%, 34%, and 29% at 12 months. No differences reached significance. Attendance was poor in all groups; 45% of community site, 58% of videoconference, and 16% of EUC participants attended at least one session. Conclusion Videoconference and community‐based delivery were as effective as an FQHC‐based weight loss program.