Computerized Weight Loss Intervention Optimizes Staff Time
Abstract
Objective To evaluate the costs and effects of incremental components of a weight-loss program.Design A 3-arm, 12-month randomized controlled clinical trial to evaluate 3 incremental levels of intervention intensity.Subjects/setting The study included 588 individuals (BMI > 25 kg/m2) in a freestanding health maintenance organizalion and achieved an 81% completion rate.Intervention Using a cognitive behavioral approach for tailoring lifestyle modification goals, the incremental levels of intervention included a) a workbook alone, b) the addition of computerized tailoring using onsite computer kiosks with touch screen monitors, and c) the addition of both computers and staff consultation.Main outcome measures Endpoints included weight parameters, lipid profile, plasma glucose, blood pressure, intervention costs, dietary intake, and physical activity.Statistical analysis performed Study endpoints were analyzed using analysis of variance for normally distributed variables and analysis of covariance to control for any baseline differences. Regression and correlation analysis assessed the relationship between weight loss and other variables.Results For the increasing levels of intervention intensity, the mean 12-month weight losses were 2.2, 4.7, and 7.4 pounds, with the respective cost per participant being $12.33, $41.99, and $133.74. The decreases in mean BMIs for these respective intervelation levels were 0.4, 0.9 and 1.2. All groups reported a decrease in energy and fat intake and an increase in blocks walked (P<.01). Intervention variables that correlated with weight loss included more computer log-ons, achieving computer-selected goals, more self-monitoring, increased walking, and decreased energy and fat intake, as well as higher attendance in staff consultation group sessions for that treatment condition. Weight loss correlated with decreases in fasting glucose and blood pressure.Applications/conclusions In a weight-loss program, computers can facilitate selecting behavioral change goals. More frequent usage resulted in greater weight loss. Staff counseling to augment the computer intervention achieved the most weight loss.
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Two of the studies comparing an interactive computer-based intervention with a minimal or no treatment control condition were three-arm trials, and both reported no significant difference between the two computer intervention arms.
“Two of the studies comparing an interactive computer-based intervention with a minimal or no treatment control condition (Schroder 2010; Wylie-Rosett 2001) were three-arm trials, in which a third treatment arm supplemented the computer-based intervention with an in-person treatment component. Both studies reported that there was not a significant difference between the two computer intervention ar”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
Wylie-Rosett 2001 reported that the study completers did not differ significantly from the dropouts with respect to baseline characteristics, but did not otherwise state how missing data were handled.
“Wylie-Rosett 2001 reported that the study completers did not differ significantly from the dropouts with respect to baseline characteristics, but did not otherwise state how missing data were handled.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
In Wylie-Rosett 2001, at 12 months, the decrease in percent calories from fat was not significantly different between intervention arms when all computer intervention participants were included (MD 0.6%, 95% CI −1.0 to 2.3; P = 0.45; 474 participants).
“In a second study (Wylie-Rosett 2001), the decrease in percent calories from fat at 12 months was not significantly different between intervention arms, whether all computer intervention participants were included in the analysis (MD 0.6% (95% CI −1.0 to 2.3); P = 0.45; 474 participants; Analysis 1.16; primary analysis 1.16.1)”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
In Wylie-Rosett 2001, participants in the control arm decreased their caloric intake slightly more than participants in the computer intervention arm at 12 months follow-up, although the difference was small and not significant at P < 0.05 for the analysis including all participants (MD 94 kcal/day, 95% CI -29 to 217, P = 0.14; 474 participants) or for the analysis excluding intervention particip
“In a third study (Wylie-Rosett 2001), which followed participants to 12 months, participants in the control arm decreased their caloric intake slightly more than participants in the computer intervention arm at 12 months follow-up, although the difference was small and not significant at P < 0.05 for the analysis including all participants (MD 94 kcal/day (95% CI −29 to 217); P = 0.14; 474”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
In the single study reporting percent weight loss at 12 months (Wylie-Rosett 2001), participants in the computer intervention lost a greater percentage of body weight than participants in the control group (MD -2.0%, 95% CI -3.1 to -0.8, P = 0.0008; 474 participants), although this effect was smaller and no longer statistically significant when participants receiving additional in-person cons
“In the single study reporting percent weight loss at 12 months (Wylie-Rosett 2001), participants in the computer intervention lost a greater percentage of body weight than participants in the control group (MD −2.0% (95% CI −3.1 to −0.8); P = 0.0008; 474 participants; Analysis 1.5; primary analysis 1.5.1), although this effect was smaller and no longer statistically significant when participants”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
In Wylie-Rosett 2001, at 12 months, the decrease in percent calories from fat was not significantly different between intervention arms when those receiving in-person treatment components were excluded (MD 1.4%, 95% CI −0.4 to 3.2; P = 0.12; 280 participants).
“or those receiving in-person treatment components were excluded from the analysis (MD 1.4% (95% CI −0.4 to 3.2); P = 0.12; 280 participants; one trial; Analysis 1.16; sensitivity analysis 1.16.1).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
After 12 months of treatment, participants in the computer-based intervention lost more weight than participants in the control intervention (MD -1.8 kg, 95% CI -3.1 to -0.5, P = 0.009; 474 participants; one trial).
“After 12 months of treatment, participants in the computer-based intervention lost more weight than participants in the control intervention (MD −1.8 kg (95% CI −3.1 to −0.5); P = 0.009; 474 participants; one trial; Analysis 1.3: primary analysis 1.3.1).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
The intervention from Wylie-Rosett and colleagues cost EUR 38.6 per participant and led to an average participant loss of 4.0% of body weight.
“The intervention from Wylie-Rosett and colleagues cost EUR 38.6 per participant and led to an average participant loss of 4.0% of body weight.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
Cost-effectiveness analyses are often done from the perspective of the employer or the managed care organization, who pay for a large percentage of care in the U.S., and such organizations pay very little for the direct care of overweight and obesity, other than for surgery.
“In addition, while these analyses are often done from the perspective of the employer or the managed care organization, who pay for a large percentage of care in the U.S., such organizations pay very little for the direct care of overweight and obesity, other than for surgery (Wylie-Rosett 2001).”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
Only one study (Wylie-Rosett 2001) examined 12-month outcomes versus minimal treatment and only one study (Tate 2003) examined 12-month outcomes as an adjunct to an Internet intervention.
“Only one study (Wylie-Rosett 2001) examined 12-month outcomes versus minimal treatment and only one study (Tate 2003) examined 12-month outcomes as an adjunct to an Internet intervention.”
From Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people (2012) · cites this paper as Wylie-Rosett 2001
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- Authors
- WYLIE-ROSETT, J., SWENCIONIS, C., GINSBERG, M., CIMINO, C., WASSERTHEIL-SMOLLER, S., CABAN, A., SEGAL-ISAACSON, C., MARTIN, T., & LEWIS, J.
- Affiliations
- Albert Einstein College of Medicine (US)
- University of New Hampshire (US)
- Venue
- Journal of the American Dietetic Association
- Publisher
- Elsevier BV
- Published
- 2001-10
- Volume
- 101
- Issue
- 10
- Pages
- 1155-1162
- ISSN
- 0002-8223 (ISSN-L)
- OpenAlex
- W167057333
- Cited by
- 96
- References
- 35
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 3 · 2015: 3 · 2014: 6 · 2012: 6
- FWCI
- 3.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Dietetic Association (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl050372-05)
- National Heart, Lung, and Blood Institute (R01 HL50372)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK20451)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- weight loss interventions, computer-based intervention, cognitive behavioral therapy, lifestyle modification, intervention intensity, cost-effectiveness, employee consultation, self-monitoring, dietary intake, physical activity, obesity, health maintenance organizations, goal setting
- MeSH terms
- Analysis of Variance, Energy Intake, Cardiovascular Diseases, Computer-Assisted Instruction, Costs and Cost Analysis, Dietary Services, Female, Humans, Life Style, Male, Managed Care Programs, Middle Aged, Obesity, Risk Factors, Weight Loss, Exercise, Cognitive Behavioral Therapy, Body Mass Index, Nutritional Sciences
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