Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, Ste 1220, Chicago, IL 60611, USA.
JAMA Intern Med. 2013 Jan 28;173(2):105-11. doi: 10.1001/jamainternmed.2013.1221.
A challenge in intensive obesity treatment is making care scalable. Little is known about whether the outcome of physician-directed weight loss treatment can be improved by adding mobile technology.
We conducted a 2-arm, 12-month study (October 1, 2007, through September 31, 2010). Seventy adults (body mass index >25 and ≤40 [calculated as weight in kilograms divided by height in meters squared]) were randomly assigned either to standard-of-care group treatment alone (standard group) or to the standard and connective mobile technology system (+mobile group). Participants attended biweekly weight loss groups held by the Veterans Affairs outpatient clinic. The +mobile group was provided personal digital assistants to self-monitor diet and physical activity; they also received biweekly coaching calls for 6 months. Weight was measured at baseline and at 3-, 6-, 9-, and 12-month follow-up.
Sixty-nine adults received intervention (mean age, 57.7 years; 85.5% were men). A longitudinal intent-to-treat analysis indicated that the +mobile group lost a mean of 3.9 kg more (representing 3.1% more weight loss relative to the control group; 95% CI, 2.2-5.5 kg) than the standard group at each postbaseline time point. Compared with the standard group, the +mobile group had significantly greater odds of having lost 5% or more of their baseline weight at each postbaseline time point (odds ratio, 6.5; 95% CI, 2.5-18.6).
The addition of a personal digital assistant and telephone coaching can enhance short-term weight loss in combination with an existing system of care. Mobile connective technology holds promise as a scalable mechanism for augmenting the effect of physician-directed weight loss treatment.
clinicaltrials.gov Identifier: NCT00371462.
肥胖治疗的一个挑战是使治疗具有可扩展性。目前尚不清楚通过添加移动技术是否可以改善医生指导的减肥治疗的结果。
我们进行了一项为期 12 个月的双臂研究（2007 年 10 月 1 日至 2010 年 9 月 31 日）。70 名成年人（体重指数> 25 且≤40 [体重以千克为单位除以身高的平方米]）被随机分配到标准护理组单独治疗（标准组）或标准和连接性移动技术系统（+移动组）。参与者参加了退伍军人事务门诊诊所举办的每两周一次的减肥小组。+移动组被提供个人数字助理来自我监测饮食和身体活动；他们还在 6 个月内接受了每两周一次的辅导电话。在基线和 3、6、9 和 12 个月的随访时测量体重。
69 名成年人接受了干预（平均年龄 57.7 岁；85.5%为男性）。纵向意向治疗分析表明，与对照组相比，+移动组在每个基线后时间点平均多减轻了 3.9 公斤（表示体重减轻相对对照组增加了 3.1%；95%置信区间，2.2-5.5 公斤）。与标准组相比，+移动组在每个基线后时间点有更大的可能性减轻了基线体重的 5%或更多（优势比，6.5；95%置信区间，2.5-18.6）。
个人数字助理和电话辅导的添加可以增强与现有护理系统相结合的短期减肥效果。移动连接技术有望成为增强医生指导的减肥治疗效果的可扩展机制。
clinicaltrials.gov 标识符：NCT00371462。
