title: A Randomized Clinical Trial of a Tailored Lifestyle Intervention for Obese, Sedentary, Primary Care Patients.
abstract: The aim of the study was to test a tailored lifestyle intervention for helping obese primary care patients achieve weight loss and increase physical activity.
  
  
  
  We conducted a 24-month randomized clinical trial in Rhode Island. Primary care physicians identified obese, sedentary patients motivated to lose weight and increase their moderate to vigorous physical activity. These patients were randomized to 1 of 2 experimental groups: enhanced intervention (EI) or standard intervention (SI). Both groups received 3 face-to-face weight loss meetings. The enhanced intervention group also received telephone counseling calls, individually tailored print materials, and DVDs focused on diet and physical activity. Active intervention occurred in year 1 with a tapered maintenance phase in year 2.
  
  
  
  Two hundred eleven obese, sedentary patients were recruited from 24 primary care practices. Participants were 79% women and 16% minorities. They averaged 48.6 years of age, with a mean body mass index (BMI) of 37.8 kg/m(2), and 21.2 minutes/week of moderate to vigorous physical activity. Significantly more EI participants lost 5% of their baseline weight than SI participants (group by visit, P <.001). The difference was significant during active treatment at 6 months (37.2% EI vs 12.9% SI) and 12 months (47.8% vs 11.6%), but was no longer significant during the maintenance phase at 18 months (31.4% vs 26.7%,) or 24 months (33.3% vs 24.6%). The EI group reported significantly more minutes of moderate to vigorous physical activity over time than the SI group (group by visit, P = 0.04). The differences in minutes per week at 6 months was 95.7 for the EI group vs 68.3 minutes for the SI group; at 12 months, it was 126.1 vs 73.7; at 18 months, 103.7 vs 63.7, and at 24 months, 101.3 vs 75.4. Similar trends were found for absolute weight loss and the percentage reaching national guidelines for physical activity.
  
  
  
  A home-based tailored lifestyle intervention in obese, sedentary primary care patients was effective in promoting weight loss and increasing moderate to vigorous physical activity, with the effects peaking at 12 months but waning at 24 months.
authors.affiliation: Alpert Medical School of Brown University, Providence, Rhode Island Department of Epidemiology, School of Public Health of Brown University, Providence, Rhode Island Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island CEaton@CareNE.org.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California Cancer Prevention and Control, UC San Diego Moores Cancer Center, La Jolla, California.
authors.forename: Sheri J
authors.initials: SJ
authors.lastname: Hartman
authors.affiliation: Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Perzanowski
authors.affiliation: Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island.
authors.forename: Guohui
authors.initials: G
authors.lastname: Pan
authors.affiliation: Center for Primary Care and Prevention, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Roberts
authors.affiliation: Department of Epidemiology, School of Public Health of Brown University, Providence, Rhode Island Institute for Community Health Promotion, School of Public Health, Brown University, Providence, Rhode Island.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Risica
authors.affiliation: Institute for Community Health Promotion, School of Public Health, Brown University, Providence, Rhode Island Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island Department of Human Development and Family Studies, University of Connecticut, Storrs, Connecticut Center for Health Interventions and Prevention, University of Connecticut, Storrs, Connecticut.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Gans
authors.affiliation: Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: John M
authors.initials: JM
authors.lastname: Jakicic
authors.affiliation: Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California.
authors.forename: Bess H
authors.initials: BH
authors.lastname: Marcus
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003376:Counseling; D015444:Exercise / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D011320:Primary Health Care / Q000458:organization & administration*; D057185:Sedentary Behavior; D016037:Single-Blind Method; D015431:Weight Loss / Q000502:physiology; D061217:Weight Reduction Programs / Q000458:organization & administration*
keywords: obesity; physical activity; primary care; randomized clinical trial; translational research