Pilot test of an interactive obesity treatment approach among employed adults in a university medical billing office

Rachel G Tabak; Jaime R Strickland; Bridget Kirk; Ryan Colvin; Richard I Stein; Hank Dart; Graham A Colditz; Ann Marie Dale; Bradley A Evanoff

doi:10.1186/s40814-020-00599-w

Pilot test of an interactive obesity treatment approach among employed adults in a university medical billing office

Pilot Feasibility Stud. 2020 Apr 28:6:57. doi: 10.1186/s40814-020-00599-w. eCollection 2020.

Authors

Rachel G Tabak¹, Jaime R Strickland², Bridget Kirk², Ryan Colvin², Richard I Stein³, Hank Dart⁴, Graham A Colditz⁵, Ann Marie Dale², Bradley A Evanoff²

Affiliations

¹ 1The Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130 USA.
² 2Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA.
³ 3Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8031, St. Louis, MO 63110 USA.
⁴ 4Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St Louis, MO 63110 USA.
⁵ 5Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110 USA.

Abstract

Background: There is a need for workplace programs promoting healthy eating and activity that reach low-wage employees and are scalable beyond the study site. Interventions designed with dissemination in mind aim to utilize minimal resources and to fit within existing systems. Technology-based interventions have the potential to promote healthy behaviors and to be sustainable as well as scalable. We developed an interactive obesity treatment approach (iOTA), to be delivered by SMS text messaging, and therefore accessible to a broad population. The aim of this pilot study was to evaluate participant engagement with, and acceptability of, this iOTA to promote healthy eating and activity behaviors among low-wage workers with obesity.

Methods: Twenty participants (self-reporting body mass index ≥ 30 kg/m²) of a single workgroup employed by a university medical practice billing office had access to the full intervention and study measures and provided feedback on the experience. Height and weight were measured by trained research staff at baseline. Each participant was offered a quarterly session with a health coach. Measured weight and a self-administered survey, including dietary and activity behaviors, were also collected at baseline, 3, 6, 12, 18, and 24 months. Participant engagement was assessed through responsiveness to iOTA SMS text messages throughout the 24-month pilot. A survey measure was used to assess satisfaction with iOTA at 3 months. Due to the small sample size and pilot nature of the current study, we conducted descriptive analyses. Engagement, weight change, and duration remaining in coaching are presented individually for each study participant.

Results: The pilot was originally intended to last 3 months, but nearly all participants requested to continue; we thus continued for 24 months. Most (14/20) participants remained in coaching for 24 months. At the 3-month follow-up, eight (47%) of the remaining 17 participants had lost weight; by 24 months, five (36%) of the remaining 14 participants had lost weight (one had bariatric surgery). Participants reported very high satisfaction.

Conclusions: This pilot provides important preliminary results on acceptability and participant engagement with iOTA, which has significant potential for dissemination and sustainability.

Abstract

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