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Randomized Controlled Trial
. 2016 May:48:12-20.
doi: 10.1016/j.cct.2016.03.006. Epub 2016 Mar 17.

Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients

Perry Foley  1 , Dori Steinberg  2 , Erica Levine  3 , Sandy Askew  4 , Bryan C Batch  5 , Elaine M Puleo  6 , Laura P Svetkey  7 , Hayden B Bosworth  8 , Abigail DeVries  9 , Heather Miranda  10 , Gary G Bennett  11
Affiliations
Randomized Controlled Trial

Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients

Perry Foley et al. Contemp Clin Trials. 2016 May.

Abstract

Introduction: Obesity continues to disproportionately affect medically vulnerable populations. Digital health interventions may be effective for delivering obesity treatment in low-resource primary care settings.

Methods: Track is a 12-month randomized controlled trial of a digital health weight loss intervention in a community health center system. Participants are 351 obese men and women aged 21 to 65years with an obesity-related comorbidity. Track participants are randomized to usual primary care or to a 12-month intervention consisting of algorithm-generated tailored behavior change goals, self-monitoring via mobile technologies, daily self-weighing using a network-connected scale, skills training materials, 18 counseling phone calls with a Track coach, and primary care provider counseling. Participants are followed over 12months, with study visits at baseline, 6, and 12months. Anthropometric data, blood pressure, fasting lipids, glucose and HbA1C and self-administered surveys are collected. Follow-up data will be collected from the medical record at 24months.

Results: Participants are 68% female and on average 50.7years old with a mean BMI of 35.9kg/m(2). Participants are mainly black (54%) or white (33%); 12.5% are Hispanic. Participants are mostly employed and low-income. Over 20% of the sample has hypertension, diabetes and hyperlipidemia. Almost 27% of participants currently smoke and almost 20% score above the clinical threshold for depression.

Conclusions: Track utilizes an innovative, digital health approach to reduce obesity and chronic disease risk among medically vulnerable adults in the primary care setting. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk patient population in need of evidence-based obesity treatment.

Trial registration: ClinicalTrials.gov NCT01827800.

Keywords: Digital health; Minority health; Mobile health; Obesity; Primary care; Rural health; Weight loss.

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Figures

Figure 1
Figure 1
CONSORT diagram for Track Study
Figure 2
Figure 2
Example of Track text message
Figure 3
Figure 3
Sample Track Update sent to PCPs via the EHR
See this image and copyright information in PMC

References

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    1. Bleich SN, Pickett-Blakely O, Cooper LA. Physician practice patterns of obesity diagnosis and weight-related counseling. Patient education and counseling. 2011;82(1):123–129. - PMC - PubMed
    1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among adults: United States, 2011-2012. NCHS data brief. 2013;(131):1–8. - PubMed
    1. Kahng SK, Dunkle RE, Jackson JS. The relationship between the trajectory of body mass index and health trajectory among older adults - Multilevel modeling analyses. Res Aging. 2004;26(1):31–61.

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