title: Influence of Patient-Centered Decision Making on Sustained Weight Loss and Risk Reduction Following Lifestyle Intervention Efforts in Rural Pennsylvania.
abstract: The purpose of this study was to determine whether weight loss and cardiovascular disease risk factor reduction was maintained following a lifestyle intervention.
  
  
  
  Five hundred fifty-five individuals without diabetes from 8 rural communities were screened for BMI ≥25 kg/m(2) and abdominal obesity (86.1% female, 95.1% white, 55.8% obese). Communities and eligible participants (n = 493; mean age, 51 years, 87.6% female, 94.1% Caucasian) were assigned to 4 study groups: face-to-face, DVD, Internet, and self-selection (SS) (n = 101). Self-selection participants chose the intervention modality (60% face-to-face, 40% Internet, 0% DVD). Outcomes included weight change and risk factor reduction at 18 months.
  
  
  
  All groups achieved maintenance of 5% weight loss in over half of participants. Self-selection participants had the largest proportion maintain (89.5%). Similarly, nearly 75% of participants sustained risk factor reduction. After multivariate adjustment, participants in SS were 2.3 times more likely to maintain 5% weight loss compared to the other groups, but not risk factor reduction.
  
  
  
  Despite the modality, lifestyle intervention was effective at maintaining weight loss and risk reduction. However, SS participants were twice as likely to sustain improvements compared to other groups. The importance of patient-centered decision making in health care is paramount.
authors.affiliation: Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan (Dr Piatt)
authors.forename: Gretchen A
authors.initials: GA
authors.lastname: Piatt
authors.affiliation: Chatham University, Pittsburgh, Pennsylvania (Ms Seidel)
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Seidel
authors.affiliation: Department of Exercise Science, Marshall University, Huntington, West Virginia (Dr Powell)
authors.forename: Robert O
authors.initials: RO
authors.lastname: Powell
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Florida College of Public Health, Tampa, Florida (Dr Zgibor)
authors.forename: Janice C
authors.initials: JC
authors.lastname: Zgibor
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003657:Decision Making; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D065228:Non-Randomized Controlled Trials as Topic; D050177:Overweight / Q000523:psychology* / Q000628:therapy; D010414:Pennsylvania; D011446:Prospective Studies; D040242:Risk Reduction Behavior; D012424:Rural Population / Q000706:statistics & numerical data; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*