ABSTRACT
BACKGROUND: Obesity is a leading contributor to disability. Treatment approaches incorporating telehealth technologies are becoming increasingly popular in treating obesity, but their benefits relative to established behavioural weight loss therapies are poorly understood. The objective of this study was to compare a new telehealth treatment (TeleMOVE) to an established behavioural treatment (MOVE!) among Veterans with obesity. METHODS: This was an observational study of Veterans in the TeleMOVE or MOVE! programs between October, 2011 and March, 2013. A total of 699 Veterans enrolled in these programs from 2011-2013. A secondary focus was on Veterans that were ≥90% adherent to their treatment. From this group, 72 (33.1%) TeleMOVE and 141 (29.3%) MOVE! participants met adherence criteria. The primary outcome criterion was changes in body weight. RESULTS: Both programs were associated with significant weight reductions, with MOVE! participants showing significantly less weight loss relative to those in TeleMOVE (MOVE! mean weight loss=4.5[7.1]lb/2.0[3.2]kg; 1.8% mean weight loss; 12.0% achieving ≥5% weight loss; TeleMOVE mean weight loss=8.6[9.9]lb/3.9[4.5]kg; 3.6% mean weight loss; 26.6% achieving ≥5% weight loss, p's<.01). Among highly adherent participants, patients in TeleMOVE versus MOVE! lost significantly more weight (TeleMOVE=11.1[9.9]lb/5.0[4.5]kg versus MOVE!=5.7[7.1]lb/2.6[3.2]kg; t=4.6, p<.001) and were significantly more likely to achieve clinically significant weight loss (% with ≥5% weight loss were 43.1% versus 13.5%, respectively, p<.001). CONCLUSIONS: In this observational study, TeleMOVE was at least as effective for weight loss as the more established multidisciplinary MOVE!
Subject(s)
Behavior Therapy/methods , Obesity/therapy , Patient Compliance , Telemedicine , Veterans , Weight Reduction Programs/methods , Aged , Female , Humans , Male , Middle Aged , Obesity/psychology , Program Evaluation , Treatment Outcome , Weight LossABSTRACT
BACKGROUND: The rates of overweight and obesity are high among United States Veterans, necessitating the development of accessible weight reduction interventions. PURPOSE: This observational study evaluated the efficacy of a novel home-based telehealth weight loss intervention (TeleMOVE) for Veterans with obesity. METHODS: We obtained weight measures of 171 patients before and after one and two 90-day cycles of TeleMOVE. RESULTS: Enrollment in the first 90-day cycle of TeleMOVE was associated with significant weight loss (M = 8.62 lbs, SD = 9.85). Those who subsequently enrolled in the second, identical, cycle lost significantly more weight overall (M = 11.68 lbs, SD = 12.53) than those who only enrolled in the first cycle (M = 5.55 lbs, SD = 8.23). However, this difference was due to two-cycle participants losing significantly more weight during the first cycle alone (M = 10.52, SD = 10.32). CONCLUSIONS: TeleMOVE is a promising intervention, warranting a further investigation of its efficacy.
Subject(s)
Obesity/therapy , Telemedicine/methods , Veterans , Weight Loss , Female , Humans , Male , Middle AgedABSTRACT
We investigated first-person plural pronoun use (we-talk) by health-compromised smokers and their spouses as a possible implicit marker of adaptive, problem-resolving communal processes. Twenty couples in which one or both partners used tobacco despite one of them having a heart or lung problem participated in up to 10 sessions of a smoking cessation intervention designed to promote communal coping, where partners define smoking as "our" problem, rather than "your" problem or "my" problem, and take collaborative action to solve it. We used the Linguistic Inquiry Word Count automatic text analysis program to tabulate first-person pronoun use by both partners from transcripts of a pretreatment marital interaction task and later intervention sessions. Results indicated that pretreatment we-talk by the patient's spouse predicted whether the patient remained abstinent 12 months after quitting, and residualized change in we-talk by both partners during the course of intervention (controlling for baseline levels) predicted cessation outcomes as well. These findings add to evidence regarding the prognostic significance of partner we-talk for patient health and provide preliminary documentation of communal coping as a possible mechanism of change in couple-focused intervention.
