title: Track: A randomized controlled trial of a digital health obesity treatment intervention for medically vulnerable primary care patients.
abstract: Obesity continues to disproportionately affect medically vulnerable populations. Digital health interventions may be effective for delivering obesity treatment in low-resource primary care settings.
  
  
  
  Track is a 12-month randomized controlled trial of a digital health weight loss intervention in a community health center system. Participants are 351 obese men and women aged 21 to 65years with an obesity-related comorbidity. Track participants are randomized to usual primary care or to a 12-month intervention consisting of algorithm-generated tailored behavior change goals, self-monitoring via mobile technologies, daily self-weighing using a network-connected scale, skills training materials, 18 counseling phone calls with a Track coach, and primary care provider counseling. Participants are followed over 12months, with study visits at baseline, 6, and 12months. Anthropometric data, blood pressure, fasting lipids, glucose and HbA1C and self-administered surveys are collected. Follow-up data will be collected from the medical record at 24months.
  
  
  
  Participants are 68% female and on average 50.7years old with a mean BMI of 35.9kg/m(2). Participants are mainly black (54%) or white (33%); 12.5% are Hispanic. Participants are mostly employed and low-income. Over 20% of the sample has hypertension, diabetes and hyperlipidemia. Almost 27% of participants currently smoke and almost 20% score above the clinical threshold for depression.
  
  
  
  Track utilizes an innovative, digital health approach to reduce obesity and chronic disease risk among medically vulnerable adults in the primary care setting. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk patient population in need of evidence-based obesity treatment.
authors.affiliation: Duke Global Digital Health Science Center, Duke Global Health Institute, 310 Trent Drive, Box 90519, Durham, NC 27710, USA. Electronic address: perry.foley@duke.edu.
authors.forename: Perry
authors.initials: P
authors.lastname: Foley
authors.affiliation: Duke Global Digital Health Science Center, Duke Global Health Institute, 310 Trent Drive, Box 90519, Durham, NC 27710, USA. Electronic address: dori.steinberg@duke.edu.
authors.forename: Dori
authors.initials: D
authors.lastname: Steinberg
authors.affiliation: Duke Global Digital Health Science Center, Duke Global Health Institute, 310 Trent Drive, Box 90519, Durham, NC 27710, USA. Electronic address: erica.levine@duke.edu.
authors.forename: Erica
authors.initials: E
authors.lastname: Levine
authors.affiliation: Duke Global Digital Health Science Center, Duke Global Health Institute, 310 Trent Drive, Box 90519, Durham, NC 27710, USA. Electronic address: sandy.askew@duke.edu.
authors.forename: Sandy
authors.initials: S
authors.lastname: Askew
authors.affiliation: Department of Medicine, Division of Endocrinology, Duke University Medical Center, Durham, NC 27710, USA; Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: bryan.batch@duke.edu.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Batch
authors.affiliation: School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA 01003-9304, USA. Electronic address: epuleo@schoolph.umass.edu.
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Puleo
authors.affiliation: Department of Medicine, Division of Endocrinology, Duke University Medical Center, Durham, NC 27710, USA; Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC 27710, USA. Electronic address: laura.svetkey@duke.edu.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.affiliation: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. Electronic address: hayden.bosworth@dm.duke.edu.
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.affiliation: Piedmont Health Services, Inc., Carrboro, NC 27510, USA. Electronic address: devriesa@piedmonthealth.org.
authors.forename: Abigail
authors.initials: A
authors.lastname: DeVries
authors.affiliation: Piedmont Health Services, Inc., Carrboro, NC 27510, USA. Electronic address: mirandah@piedmonthealth.org.
authors.forename: Heather
authors.initials: H
authors.lastname: Miranda
authors.affiliation: Duke Global Digital Health Science Center, Duke Global Health Institute, 310 Trent Drive, Box 90519, Durham, NC 27710, USA; Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA. Electronic address: gary.bennett@duke.edu.
authors.forename: Gary G
authors.initials: GG
authors.lastname: Bennett
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003151:Community Health Centers; D015897:Comorbidity; D003376:Counseling; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006040:Goals; D015438:Health Behavior; D006630:Hispanic or Latino; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D009657:North Carolina; D009765:Obesity / Q000453:epidemiology / Q000628:therapy*; D011320:Primary Health Care; D012424:Rural Population; D000073278:Self-Management; D017216:Telemedicine; D013689:Telephone; D035862:Vulnerable Populations; D061217:Weight Reduction Programs / Q000379:methods*; D044465:White People; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human
keywords: Digital health; Minority health; Mobile health; Obesity; Primary care; Rural health; Weight loss