Cited by 105Mobile Health and mHealth ApplicationsObesity and Health PracticesObesity, Physical Activity, Diet

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Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

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Levine, David M., Savarimuthu, Stella, Squires, Allison, Nicholson, Joseph, Jay, Melanie·2015·Journal of General Internal Medicine

DOI 10.1007/s11606-014-2987-6PMC PMC4284284

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Abstract

Background The US Preventive Services Task Force recommends screening for and treating obesity. However, there are many barriers to successfully treating obesity in primary care (PC). Technology-assisted weight loss interventions offer novel ways of improving treatment, but trials are overwhelmingly conducted outside of PC and may not translate well into this setting. We conducted a systematic review of technology-assisted weight loss interventions specifically tested in PC settings.Methods We searched the literature from January 2000 to March 2014.Inclusion criteria (1) Randomized controlled trial; (2) trials that utilized the Internet, personal computer, and/or mobile device; and (3) occurred in an ambulatory PC setting. We applied the Cochrane Effective Practice and Organization of Care (EPOC) and Delphi criteria to assess bias and the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) criteria to assess pragmatism (whether trials occurred in the real world versus under ideal circumstances). Given heterogeneity, results were not pooled quantitatively.Results Sixteen trials met inclusion criteria. Twelve (75 %) interventions achieved weight loss (range: 0.08 kg - 5.4 kg) compared to controls, while 5-45 % of patients lost at least 5 % of baseline weight. Trial duration and attrition ranged from 3-36 months and 6-80 %, respectively. Ten (63 %) studies reported results after at least 1 year of follow-up. Interventions used various forms of personnel, technology modalities, and behavior change elements; trials most frequently utilized medical doctors (MDs) (44 %), web-based applications (63 %), and self-monitoring (81 %), respectively. Interventions that included clinician-guiding software or feedback from personnel appeared to promote more weight loss than fully automated interventions. Only two (13 %) studies used publically available technologies. Many studies had fair pragmatism scores (mean: 2.8/4), despite occurring in primary care.Discussion Compared to usual care, technology-assisted interventions in the PC setting help patients achieve weight loss, offering evidence-based options to PC providers. However, best practices remain undetermined. Despite occurring in PC, studies often fall short in utilizing pragmatic methodology and rarely provide publically available technology. Longitudinal, pragmatic, interdisciplinary, and open-source interventions are needed.

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Authors: Levine, D. M., Savarimuthu, S., Squires, A., Nicholson, J., & Jay, M.
Affiliations: New York University (US)
Hofstra University (US)
VA NY Harbor Healthcare System (US)
Corresponding author: Levine, David M.
ORCID: Levine, David M.
Savarimuthu, Stella
Squires, Allison
Jay, Melanie
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2014-08-19
Volume: 30
Issue: 1
Pages: 107-117
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-014-2987-6
PMC: PMC4284284
OpenAlex: W2018124350
Cited by: 105
References: 93
Citations by year: 2026: 3 · 2025: 1 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 14 · 2020: 11 · 2019: 23 · 2018: 8 · 2017: 9 · 2016: 14 · 2015: 6 · 2014: 3
FWCI: 1.81
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of General Internal Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs (IK2 HX000762)
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: obesity treatment, primary care, online intervention, mobile health, self-monitoring, behavior change, pragmatic trials, weight loss outcomes
MeSH terms: Delivery of Health Care, Humans, Obesity, Primary Health Care, Weight Loss, Internet, Biomedical Technology, Mobile Applications

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Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

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