title: Small changes approach promotes initial and continued weight loss with a phone-based follow-up: nine-month outcomes from ASPIRES II.
abstract: OBJECTIVE
  To examine the impact of a small-changes weight loss program across a 3-month intervention followed by a 6-month follow-up program.
  
  
  METHODS
  A one-group pre-post intervention study.
  
  
  METHODS
  Medium-sized Southwestern university.
  
  
  METHODS
  Twenty-five obese adult women (mean body mass index [BMI]  =  31.8 kg/m(2), standard deviation [SD]  =  4.9).
  
  
  METHODS
  Participants were asked to choose and adopt small changes in their diet and physical activity relative to baseline during weekly group-based meetings over 3 months. Participants then received bi-weekly phone calls across a 6-month follow-up period.
  
  
  METHODS
  Weight change was the primary outcome. Secondary outcomes included waist circumference, daily step count, and caloric intake.
  
  
  METHODS
  Intention-to-treat analysis of change from baseline and completers-only analysis (n  =  22) for secondary outcomes.
  
  
  RESULTS
  Participants achieved clinically significant weight loss (mean [M]  =  -3.2 kg, standard error [SE]  =  .47 kg, p < .001) across the initial small changes treatment program. Moreover, participants continued to lose weight across the 6-month phone-based follow-up program (M  =  -2.1 kg, SE  =  .83 kg, p < .017), totaling >5% weight loss across the 9-month program (M  =  5.3 kg, SE  =  1.1 kg, p < .001).
  
  
  CONCLUSIONS
  Using a small changes approach, participants achieved weight loss in an initial group-based program, which continued with minimal phone-based follow-up. Larger randomized studies comparing a small changes approach to traditional obesity treatment are warranted.
authors.affiliation: Department of Psychology, East Carolina University, Greenville, North Carolina 27858, USA. lutesl@ecu.edu
authors.forename: Lesley D
authors.initials: LD
authors.lastname: Lutes
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Daiss
authors.forename: Steven D
authors.initials: SD
authors.lastname: Barger
authors.forename: Margaret
authors.initials: M
authors.lastname: Read
authors.forename: Emily
authors.initials: E
authors.lastname: Steinbaugh
authors.forename: Richard A
authors.initials: RA
authors.lastname: Winett
mesh_terms: D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D011446:Prospective Studies; D013689:Telephone; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*