ABSTRACT
BACKGROUND
The Diabetes Prevention Program (DPP) intensive lifestyle intervention resulted in significant weight loss, reducing the development of diabetes, but needs to be adapted to primary care provider (PCP) practices.
OBJECTIVES
To compare a DPP-translation using individual (IC) vs. conference (CC) calls delivered by PCP staff for the outcome of percent weight loss over 2 years.
DESIGN
Randomized clinical trial.
SETTING
Five PCP sites.
PARTICIPANTS
Obese patients with metabolic syndrome, without diabetes (IC, n = 129; CC, n = 128).
INTERVENTION
Telephone delivery of the DPP Lifestyle Balance intervention [16-session core curriculum in year 1, 12-session continued telephone contact in year 2 plus telephone coaching sessions (dietitians).
MAIN MEASURES
Weight (kg), body mass index (BMI), and waist circumference.
KEY RESULTS
Baseline data: age = 52 years, BMI = 39 kg/m2, 75 % female, 85 % non-Hispanic White, 13 % non-Hispanic Black, and 48 % annual incomes <$40,000/year. In the intention-to-treat analyses at year 2, mean percent weight loss was −5.6 % (CC, p < 0.001) and −1.8 % (IC, p = 0.046) and was greater for CC than for IC (p = 0.016). At year 2, mean weight loss was 6.2 kg (CC) and 2.2 kg (IC) (p < 0.001). There was similar weight loss at year 1, but between year 1 and year 2 CC participants continued to lose while IC participants regained. At year 2, 52 % and 43 % (CC) and 29 % and 22 % (IC) of participants lost at least 5 % and 7 % of initial weight. BMI also decreased more for CC than IC (−2.1 kg/m2 vs. −0.8 kg/m2 p < 0.001). Waist circumference decreased by 3.1 cm (CC) and 2.4 cm (IC) at year 2. Completers (≥9 of 16 sessions; mean 13.3 sessions) lost significantly more weight than non-completers (mean 4.3 sessions).
CONCLUSIONS
PCP staff delivery of the DPP lifestyle intervention by telephone can be effective in achieving weight loss in obese people with metabolic syndrome. Greater weight loss may be attained with a group telephone intervention.
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Acknowledgments
Contributors
We thank our participants, their primary care providers, the health care professionals who served as educators and our dietitian coaches. We also thank Julie J. Stone, RN, for performing the participant assessments and Jane D. Bulger, MS, CCRC, and Michael J. Wade, MS, for facilitating data collection and data entry.
Funders
This study was supported by grant R18-DK078553 from the National Institutes of Health (NIDDK; Trief and Weinstock PIs).
Prior presentations
Some of these findings were published in abstract form and presented in oral sessions at the annual meeting of the American Diabetes Association meeting in June 2012 and June 2013.
Conflict of Interest
The authors declare that they do not have any conflicts of interest.
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Trial Registration: clinicaltrials.gov Identifier: NCT00749606
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Weinstock, R.S., Trief, P.M., Cibula, D. et al. Weight Loss Success in Metabolic Syndrome by Telephone Interventions: Results from the SHINE Study. J GEN INTERN MED 28, 1620–1628 (2013). https://doi.org/10.1007/s11606-013-2529-7
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DOI: https://doi.org/10.1007/s11606-013-2529-7