Beeken, RJ;
Leurent, B;
Vickerstaff, V;
Wilson, R;
Croker, H;
Morris, S;
Omar, RZ;
... Wardle, J; + view all
(2017)
A brief intervention for weight control based on habit-formation theory delivered through primary care: Results from a randomised controlled trial.
International Journal of Obesity
, 41
pp. 246-254.
10.1038/ijo.2016.206.
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Abstract
BACKGROUND: Primary care is the 'first port of call' for weight control advice, creating a need for simple, effective interventions that can be delivered without specialist skills. Ten Top Tips (10TT) is a leaflet based on habit-formation theory that could fill this gap. The aim of the current study was to test the hypothesis that 10TT can achieve significantly greater weight loss over three months than 'usual care'. METHODS: A two-arm, individually-randomised, controlled trial in primary care. Adults with obesity were identified from 14 primary care providers across England. Patients were randomised to either 10TT or 'usual care' and followed-up at 3, 6, 12, 18 and 24 months. The primary outcome was weight loss at 3 months, assessed by a health professional blinded to group allocation. Difference between arms was assessed using a mixed-effect linear model taking into account the health professionals delivering 10TT, and adjusted for baseline weight. Secondary outcomes included BMI, waist circumference, the number achieving a 5% weight reduction, clinical markers for potential co-morbidities, weight loss over 24 months, and basic costs. RESULTS: 537 participants were randomised to 10TT (n=267) or to 'usual care' (n=270). Data were available for 389 (72%) participants at 3 months and for 312 (58%) at 24 months. Participants receiving 10TT lost significantly more weight over three months than those receiving usual care (mean difference=-0.87 kg, 95%CI [-1.47 to -0.27], P=0.004). At 24 months the 10TT group had maintained their weight loss but the 'usual care' group had lost a similar amount. The basic cost of 10TT was low; around £23 ($32) per participant. CONCLUSIONS: The 10TT leaflet delivered through primary care is effective in the short-term and a low-cost option over the longer term. It is the first habit-based intervention to be used in a health service setting and offers a low-intensity alternative to 'usual care'. TRIAL REGISTRATION: Current Controlled Trials ISRCTN1634706: Habit-based advice for weight control in general practice (10TT Trial).International Journal of Obesity accepted article preview online, 21 November 2016. doi:10.1038/ijo.2016.206.
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