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Tailored, Interactive Text Messages for Enhancing Weight Loss Among African American Adults: The TRIMM Randomized Controlled Trial

      Abstract

      Background

      Helping patients control obesity remains a clinical challenge for internists, and African Americans experience obesity rates higher than other racial/ethnic groups.

      Purpose

      To investigate whether a behavioral theory-based mobile health intervention would enhance weight loss when added to standard care among overweight/obese African American adults.

      Methods

      A randomized controlled trial of 124 adults recruited from Baltimore-area African American churches. Participant follow-up ended March 2013. Participants were randomized to standard care (included one-on-one counseling sessions with a dietitian and a physician) or standard care plus daily tailored text messages for 6 months. Text messages were delivered in phases: preparation, reinforcement of participant-selected diet and exercise goals, reflection, goal integration, weight loss methods, and maintenance. There were follow-up visits at 3, 6, and 12 months. Primary outcome was weight change from baseline to end-intervention at 6 months. Secondary outcomes included weight change at 3 months, engagement, and satisfaction with the intervention.

      Results

      Sixty-three participants were randomized to the mobile health intervention and 61 to standard-care control. Weights were collected in-window for 45 (36.3%) at 3 months and 51 (41.1%) at 6 months. Mean weight loss at 3 months was 2.5 kg greater in the intervention group compared with standard care (95% confidence interval [CI], −4.3 to −0.6; P < .001), and 3.4 kg greater (95% CI, −5.2 to −1.7; P = .001) at 6 months. Degree of engagement with messages was correlated with weight loss.

      Conclusions

      While attrition was high, this study supports a tailored, interactive text-message intervention to enhance weight loss among obese African-American adults.

      Keywords

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