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Journal of General Internal Medicine

, Volume 34, Issue 6, pp 992–998 | Cite as

Provider Counseling and Weight Loss Outcomes in a Primary Care-Based Digital Obesity Treatment

  • Megan McVayEmail author
  • Dori Steinberg
  • Sandy Askew
  • Gary G. Bennett
Original Research

Abstract

Background

Primary care-based digital health weight loss interventions offer promise for addressing obesity in underserved populations.

Objectives

To determine if primary care providers’ weight counseling is associated with weight change during a weight loss intervention.

Design

This is a secondary analysis of a randomized clinical trial testing a 12-month primary care-based digital health weight loss intervention.

Participants

Participants were community health center patients with body mass indexes of 30–44.9 kg/m2.

Interventions

The weight loss intervention included tailored behavioral goal setting; weekly goal monitoring via text messaging or interactive voice response calls; counseling calls; skills training material; and participant-tailored recommendations for provider counseling.

Main Measures

At 6 and 12 months, participants’ weight was measured and they reported if their provider delivered weight counseling (general or intervention-specific) at their most recent visit and their perception of providers’ empathy. Providers’ documentation of weight counseling was extracted from health records.

Key Results

Participants (n = 134–141) were predominantly female (70%) and African American (55%) with a mean age of 51 years and BMI of 36 kg/m2. Participant-reported provider weight counseling was not associated with weight change. However, participants whose providers documented intervention-specific counseling at any point during the intervention (n = 35) lost 3.1 kg (95% CI 0.4 to 5.7 kg) more than those whose providers documented only general weight counseling (n = 82) and 4.0 kg (95% CI 0.1 to 7.9 kg) more than those whose providers did not document weight counseling (n = 17). Perceptions of provider empathy were associated with greater weight loss from 6 to 12 months (0.8 kg per measure unit, 95% CI 0.07 to 1.5 kg, p = .03).

Conclusions

Provider counseling that focuses specifically on engagement in a weight loss intervention may enhance weight loss outcomes relative to more general weight loss advice. Counseling that enhances patients’ perceptions of empathy may be most beneficial for patients’ weight loss.

Trial Registration

NCT 01827800

KEY WORDS

weight loss primary health care obesity community health centers vulnerable populations 

Notes

Acknowledgements

We wish to acknowledge the Track study participants and the health care providers for making this research possible. We also acknowledge the research assistants who assisted with data collection on EHR provider counseling data, Jacob Christy and Jasmine Burroughs.

Funding Information

This research is funded in part by the following grants: R01DK093829 to Dr. Gary Bennett; K23HL127334 to Dr. Megan McVay; K12HD043446 to Dr. Dori Steinberg.

Compliance with Ethical Standards

Conflict of Interest

Gary Bennett holds equity in Coeus Health, LLC, and serves on the scientific advisory board of Nutrisystem, is a member of the board of directors at Girl Trek, and is a past president and a member of the board of directors at the Society of Behavioral Medicine. All remaining authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_4944_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 17 kb)

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Megan McVay
    • 1
    Email author
  • Dori Steinberg
    • 2
    • 3
  • Sandy Askew
    • 3
  • Gary G. Bennett
    • 3
    • 4
  1. 1.Department of Health Education and BehaviorUniversity of FloridaGainesvilleUSA
  2. 2.School of NursingDuke UniversityDurhamUSA
  3. 3.Duke Global Digital Health Science Center, Duke Global Health InstituteDuke UniversityDurhamUSA
  4. 4.Department of Psychology and NeuroscienceDuke UniversityDurhamUSA

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