Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr;32(Suppl 1):24-31.
doi: 10.1007/s11606-016-3971-0.

A Quasi-Experiment to Assess the Impact of a Scalable, Community-Based Weight Loss Program: Combining Reach, Effectiveness, and Cost

Paul A Estabrooks  1 , Kathryn E Wilson  2 , Todd J McGuire  3 , Samantha M Harden  4 , NithyaPriya Ramalingam  5 , Lia Schoepke  3 , Fabio A Almeida  2 , Amy L Bayer  6
Affiliations

A Quasi-Experiment to Assess the Impact of a Scalable, Community-Based Weight Loss Program: Combining Reach, Effectiveness, and Cost

Paul A Estabrooks et al. J Gen Intern Med. 2017 Apr.

Abstract

Background: Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants.

Objective: To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics.

Design: Longitudinal pre-post quasi-experiment without control.

Participants: Enrolled participants in Weigh and Win (WAW), a community-based weight loss program.

Intervention: A 12-month program with daily social cognitive theory-based email and/or text support, online access to health coaches, objective weight assessment through 83 community-based kiosks, and modest financial incentives to increase program reach.

Main measures: Number of participants, representativeness, weight loss achievement (3%, 5% of initial weight lost), and cost of implementation.

Key results: A total of 40,308 adults (79% women; 73% white; BMI = 32.3 ± 7.44, age = 43.9 ± 13.1 years) enrolled in WAW. Women were more likely than men to enroll in the program and continue engagement beyond an initial weigh-in (57% vs. 53%). Based on census data, African Americans were over-represented in the sample. Among participants who engaged in the program beyond an initial weigh-in (n = 19,029), 47% and 34% of participants lost 3% and 5% of their initial body weight, respectively. The average duration for those who achieved 5% weight loss was 1.7 ± 1.3 years. African American participants were more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants (2.0 ± 1.3 vs. 1.6 ± 1.2 years). Implementation costs were $2,822,698. Cost per clinically meaningful weight loss for African Americans ($257.97/3% loss; $335.96/5% loss) was lower than that for Hispanics ($318.62; $431.10) and Caucasians ($313.65; $441.87), due to the higher success rate of that subgroup of participants.

Conclusions: Weigh and Win is a scalable technology-supported and community-based weight loss program that reaches a large number of participants and may contribute to reducing health disparities.

Keywords: behavioral weight Loss; cost; impact; incentives; public health.

PubMed Disclaimer

Conflict of interest statement

Lia Schoepke is employed by IncentaHEALTH LLC. Todd McGuire is employed by, holds the patent to, and is a part owner of IncentaHEALTH LLC. All other authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Participant flow diagram by quarter between 2011 and 2014.
Figure 2
Figure 2
Histogram of participant weight loss (kg) for those who completed a second weigh-in.
See this image and copyright information in PMC

References

    1. Ahmed NU, Delgado M, Saxena A. Trends and disparities in the prevalence of physicians’ counseling on diet and nutrition among the U.S. adult population, 2000-2011. Prev Med. 2016;89:70–5. doi: 10.1016/j.ypmed.2016.05.014. - DOI - PubMed
    1. Vallis M, Piccinini-Vallis H, Sharma AM, Freedhoff Y. Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care. Can Fam Physician. 2013;59:27–31. - PMC - PubMed
    1. Phillips SM, Glasgow RE, Bello G, et al. Frequency and prioritization of patient health risks from a structured health risk assessment. Ann Fam Med. 2014;12:505–13. doi: 10.1370/afm.1717. - DOI - PMC - PubMed
    1. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Journal of the American College of Cardiology 2013. - PubMed
    1. The Community Guide: Obesity prevention and control: Technology supported multicomponent coaching or counseling interventions to reduce weight and maintain weight loss. 2010. (Accessed July 10, 2016, at http://www.thecommunityguide.org/obesity/TechnologicalCoaching.html.)

MeSH terms