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Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care

Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care
Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care
Background

There is a need for cost-effective weight management interventions that primary care can deliver to reduce the morbidity caused by obesity. Automated web-based interventions might provide a solution, but evidence suggests that they may be ineffective without additional human support. The main aim of this study was to carry out a feasibility trial of a web-based weight management intervention in primary care, comparing different levels of nurse support, to determine the optimal combination of web-based and personal support to be tested in a full trial.

Methods

This was an individually randomised four arm parallel non-blinded trial, recruiting obese patients in primary care. Following online registration, patients were randomly allocated by the automated intervention to either usual care, the web-based intervention only, or the web-based intervention with either basic nurse support (3 sessions in 3 months) or regular nurse support (7 sessions in 6 months). The main outcome measure (intended as the primary outcome for the main trial) was weight loss in kg at 12 months. As this was a feasibility trial no statistical analyses were carried out, but we present means, confidence intervals and effect sizes for weight loss in each group, uptake and retention, and completion of intervention components and outcome measures.

Results

All randomised patients were included in the weight loss analyses (using Last Observation Carried Forward). At 12 months mean weight loss was: usual care group (n = 43) 2.44 kg; web-based only group (n = 45) 2.30 kg; basic nurse support group (n = 44) 4.31 kg; regular nurse support group (n = 47) 2.50 kg. Intervention effect sizes compared with usual care were: d = 0.01 web-based; d = 0.34 basic nurse support; d = 0.02 regular nurse support. Two practices deviated from protocol by providing considerable weight management support to their usual care patients.

Conclusions

This study demonstrated the feasibility of delivering a web-based weight management intervention supported by practice nurses in primary care, and suggests that the combination of the web-based intervention with basic nurse support could provide an effective solution to weight management support in a primary care context.

Trial registration

Current Controlled Trials ISRCTN31685626.
1479-5868
67
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Ware, L..J.
763b80c2-743c-400e-8306-acfbd9701261
Smith, E.R.
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Williams, S.
762dd529-2acb-40b8-acf3-e3488eec8506
Bradbury, K.J.
87fce0b9-d9c5-42b4-b041-bffeb4430863
Arden-Close, Emily
476eebfb-e256-474b-8351-09db1efdeab5
Mullee, M.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Peacock, J.L.
8362b3b1-458f-4152-936f-344ca1c7e0ba
Lean, M.E.J.
473d4e43-c6e7-4e2a-ac29-cef7e19eee65
Margetts, B.M.
d415f4a1-d572-4ebc-be25-f54886cb4788
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Hobbs, R.F.D.
10835c27-da1b-49bf-a831-b3d07287ec43
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Ware, L..J.
763b80c2-743c-400e-8306-acfbd9701261
Smith, E.R.
14999f6c-eac3-403b-b3df-f8c1bd0788ee
Williams, S.
762dd529-2acb-40b8-acf3-e3488eec8506
Bradbury, K.J.
87fce0b9-d9c5-42b4-b041-bffeb4430863
Arden-Close, Emily
476eebfb-e256-474b-8351-09db1efdeab5
Mullee, M.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Peacock, J.L.
8362b3b1-458f-4152-936f-344ca1c7e0ba
Lean, M.E.J.
473d4e43-c6e7-4e2a-ac29-cef7e19eee65
Margetts, B.M.
d415f4a1-d572-4ebc-be25-f54886cb4788
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Hobbs, R.F.D.
10835c27-da1b-49bf-a831-b3d07287ec43
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Yardley, Lucy, Ware, L..J., Smith, E.R., Williams, S., Bradbury, K.J., Arden-Close, Emily, Mullee, M., Moore, M., Peacock, J.L., Lean, M.E.J., Margetts, B.M., Byrne, Christopher D., Hobbs, R.F.D. and Little, Paul (2014) Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care. International Journal of Behavioral Nutrition and Physical Activity, 11 (1), 67. (doi:10.1186/1479-5868-11-67). (PMID:24886516)

Record type: Article

Abstract

Background

There is a need for cost-effective weight management interventions that primary care can deliver to reduce the morbidity caused by obesity. Automated web-based interventions might provide a solution, but evidence suggests that they may be ineffective without additional human support. The main aim of this study was to carry out a feasibility trial of a web-based weight management intervention in primary care, comparing different levels of nurse support, to determine the optimal combination of web-based and personal support to be tested in a full trial.

Methods

This was an individually randomised four arm parallel non-blinded trial, recruiting obese patients in primary care. Following online registration, patients were randomly allocated by the automated intervention to either usual care, the web-based intervention only, or the web-based intervention with either basic nurse support (3 sessions in 3 months) or regular nurse support (7 sessions in 6 months). The main outcome measure (intended as the primary outcome for the main trial) was weight loss in kg at 12 months. As this was a feasibility trial no statistical analyses were carried out, but we present means, confidence intervals and effect sizes for weight loss in each group, uptake and retention, and completion of intervention components and outcome measures.

Results

All randomised patients were included in the weight loss analyses (using Last Observation Carried Forward). At 12 months mean weight loss was: usual care group (n = 43) 2.44 kg; web-based only group (n = 45) 2.30 kg; basic nurse support group (n = 44) 4.31 kg; regular nurse support group (n = 47) 2.50 kg. Intervention effect sizes compared with usual care were: d = 0.01 web-based; d = 0.34 basic nurse support; d = 0.02 regular nurse support. Two practices deviated from protocol by providing considerable weight management support to their usual care patients.

Conclusions

This study demonstrated the feasibility of delivering a web-based weight management intervention supported by practice nurses in primary care, and suggests that the combination of the web-based intervention with basic nurse support could provide an effective solution to weight management support in a primary care context.

Trial registration

Current Controlled Trials ISRCTN31685626.

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1479-5868-11-67 - Version of Record
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More information

Accepted/In Press date: 13 May 2014
Published date: 21 May 2014
Organisations: Primary Care & Population Sciences, Human Development & Health

Identifiers

Local EPrints ID: 365640
URI: https://eprints.soton.ac.uk/id/eprint/365640
ISSN: 1479-5868
PURE UUID: 7153c013-9013-4749-b7a0-9b382b63becd
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for K.J. Bradbury: ORCID iD orcid.org/0000-0001-5513-7571
ORCID for M. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for Christopher D. Byrne: ORCID iD orcid.org/0000-0001-6322-7753

Catalogue record

Date deposited: 11 Jun 2014 11:30
Last modified: 07 Aug 2019 00:47

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Contributors

Author: Lucy Yardley ORCID iD
Author: L..J. Ware
Author: E.R. Smith
Author: S. Williams
Author: K.J. Bradbury ORCID iD
Author: Emily Arden-Close
Author: M. Mullee
Author: M. Moore ORCID iD
Author: J.L. Peacock
Author: M.E.J. Lean
Author: B.M. Margetts
Author: R.F.D. Hobbs
Author: Paul Little

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