Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients.

Abstract

Introduction

Obesity continues to disproportionately affect medically vulnerable populations. Digital health interventions may be effective for delivering obesity treatment in low-resource primary care settings.

Methods

Track is a 12-month randomized controlled trial of a digital health weight loss intervention in a community health center system. Participants are 351 obese men and women aged 21 to 65years with an obesity-related comorbidity. Track participants are randomized to usual primary care or to a 12-month intervention consisting of algorithm-generated tailored behavior change goals, self-monitoring via mobile technologies, daily self-weighing using a network-connected scale, skills training materials, 18 counseling phone calls with a Track coach, and primary care provider counseling. Participants are followed over 12months, with study visits at baseline, 6, and 12months. Anthropometric data, blood pressure, fasting lipids, glucose and HbA1C and self-administered surveys are collected. Follow-up data will be collected from the medical record at 24months.

Results

Participants are 68% female and on average 50.7years old with a mean BMI of 35.9kg/m(2). Participants are mainly black (54%) or white (33%); 12.5% are Hispanic. Participants are mostly employed and low-income. Over 20% of the sample has hypertension, diabetes and hyperlipidemia. Almost 27% of participants currently smoke and almost 20% score above the clinical threshold for depression.

Conclusions

Track utilizes an innovative, digital health approach to reduce obesity and chronic disease risk among medically vulnerable adults in the primary care setting. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk patient population in need of evidence-based obesity treatment.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1016/j.cct.2016.03.006

Publication Info

Foley, Perry, Dori Steinberg, Erica Levine, Sandy Askew, Bryan C Batch, Elaine M Puleo, Laura P Svetkey, Hayden B Bosworth, et al. (2016). Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients. Contemporary clinical trials, 48. pp. 12–20. 10.1016/j.cct.2016.03.006 Retrieved from https://hdl.handle.net/10161/29913.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Steinberg

Dori Steinberg

Consulting Associate in the School of Nursing

Dr. Steinberg is an Associate Professor in the Duke School of Nursing and at the Duke Global Health Institute. She is also Director of the Duke Global Digital Health Science Center. Her research focuses on digital health interventions for dietary change, and chronic disease management among adults. 

Dr. Steinberg is the PI of an NIH-funded R01 grant examining how to best leverage digital health to improve diet quality among individuals with high blood pressure. She was PI on K12 career development grant as Duke BIRCWH Scholar and has been a co-investigator on several successfully funded grants from NIH and Duke. Her work has been featured in the Journal of the American Medical Association, The Journal of the Academy of Nutrition and Dietetics and The American Journal of Public Health, as well as in mass media. 

Dr. Steinberg earned her B.S. in Nutrition from the Cornell University, her M.S. in Public Health from Harvard University, and a Ph.D. in Nutrition from the University of North Carolina at Chapel Hill. She is also a Registered Dietitian.

Batch

Bryan Courtney Batch

Professor of Medicine

Type 2 Diabetes, Obesity/Overweight, Behavior change, Non-pharmacologic intervention, Health disparities

Svetkey

Laura Pat Svetkey

Professor of Medicine

Laura P. Svetkey, MD MHS is Professor of Medicine/Nephrology, Vice Chair for Faculty Development and Diversity in the Department of Medicine. She is also the Director of Duke’s CTSA-sponsored internal career development award program (KL2) and the Associate Director of Duke’s REACH Equity Disparities Research Center, in which she also leads the Investigator Development Core.

Dr. Svetkey has over 30 years of experience in the investigation of hypertension, obesity, and related areas, conducting NIH-sponsored clinical research ranging from behavioral intervention trials to metabolomics and genetics, with a consistent focus on prevention, non-pharmacologic intervention, health disparities and minority health. Her research has affected national guidelines, having served on the 2013 national Hypertension Guideline Panel (JNC) and the Lifestyle Guideline Working Group. She is an American Society of Hypertension certified hypertension specialist, and a member of the Association of American Physicians (AAP). She is the Associate Director, Core Director and Project PI of Duke’s NIH-sponsored REACH Equity Disparities Research Center (PI: Kimberly Johnson).

As Department of Medicine Vice Chair for Faculty Development and Diversity, she implements a wide range of programs to enhance the experience and advancement of faculty and trainees, with particular emphasis on those from racial and ethnic groups under-represented in medicine, and women.


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