TY - JOUR
T1 - Group Lifestyle Balance Adapted for Individuals With Impaired Mobility
T2 - Outcomes for 6-Month RCT and Combined Groups at 12 Months
AU - Froehlich-Grobe, Katherine
AU - Betts, Andrea C.
AU - Driver, Simon J.
AU - Carlton, Danielle N.
AU - Lopez, Amber Merfeld
AU - Lee, Jaehoon
AU - Kramer, M. Kaye
N1 - Funding Information:
The authors would like to thank those involved with this study, whose collective efforts contributed to its success: the participants, their families, and support partners; the national advisory board members who guided efforts in adapting the curriculum and delivery; and the project officers Ms. Mary Helen Witten and Dr. Joanne Thierry. This publication was supported by the Disability and Research Dissemination Center (DRDC) through its Grant Number 5U01DD001007 and FAIN No. U01DD001007 from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of DRDC or CDC. Ms. Betts is supported by a predoctoral fellowship, University of Texas Health Science Center at Houston, School of Public Health Cancer Education and Career Development Program (National Cancer Institute/NIH Grant T32 CA057712). Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the DRDC, CDC, National Cancer Institute, or NIH. The study was approved by IRBs at UTHealth School of Public Health # HSC-SPH-15-0011 and Baylor Research Institute #15-049. Author contributions: KF-G conceived of and designed the study, oversaw implementation and data acquisition and analysis, interpreted the results, and drafted and critically revised the work. SD contributed to the study design and measures selection, facilitated the acquisition of data, interpreted the results, and critically revised the work. ACB contributed to the study design and measures selection, implemented the intervention, acquired data, and drafted and critically revised the work. DC implemented the intervention, acquired data, and drafted and critically revised the work. AML acquired data and drafted and critically revised the work. JL contributed to the study design and measures selection, designed and executed the analyses, and drafted and critically revised the work. MKK contributed to the study design and measures selection, interpreted the results, and critically revised the work. All authors read and approved the final version. This research has been presented at several conferences, including American Congress of Rehabilitation (2015), American Association of Physiatrists (2016), American Public Health Association (2016), and Texas Public Health Association (2017). M. Kaye Kramer is an employee of Spark360, a commercial company that provides Group Lifestyle Balance Diabetes Prevention Program training opportunities. No other financial disclosures were reported by the authors of this paper.
Funding Information:
The authors would like to thank those involved with this study, whose collective efforts contributed to its success: the participants, their families, and support partners; the national advisory board members who guided efforts in adapting the curriculum and delivery; and the project officers Ms. Mary Helen Witten and Dr. Joanne Thierry. This publication was supported by the Disability and Research Dissemination Center (DRDC) through its Grant Number 5U01DD001007 and FAIN No. U01DD001007 from the Centers for Disease Control and Prevention (CDC) . Its contents are solely the responsibility of the authors and do not necessarily represent the official views of DRDC or CDC . Ms. Betts is supported by a predoctoral fellowship, University of Texas Health Science Center at Houston , School of Public Health Cancer Education and Career Development Program ( National Cancer Institute/NIH Grant T32 CA057712 ).
Publisher Copyright:
© 2020 American Journal of Preventive Medicine
PY - 2020/12
Y1 - 2020/12
N2 - Introduction: This study examines the feasibility and effectiveness of an intensive lifestyle intervention adapted for people with impaired mobility. Study design: This was a randomized, wait-list controlled trial. The experimental group immediately received the 12-month weight loss program; the wait-list control group received it after a 6-month delay. Between-group comparisons were conducted for the 6-month RCT study design. Repeated measures were conducted for both groups combined after receiving the 12-month intervention. Data were collected August 2015–February 2017 and analyzed in 2017. Setting/participants: A community-based sample received 23, group-based sessions via a mix of telephone and in-person sessions in a hospital-based setting. Participants with impaired mobility (n=66) were middle-aged (49.80 [SD=11.37] years), mostly White (66.7%), female (66.7%), and most commonly had spinal cord injury (47.0%). Intervention: The 12-month intervention delivered 23 group-based sessions that promoted weight loss through reducing caloric intake and increasing physical activity. Main outcome measures: Primary outcomes were effectiveness measured as change in weight and time spent in moderate physical activity. Feasibility was assessed in 12-month combined group analyses, measured as retention, attendance, and dietary self-monitoring. Results: The 6-month RCT results showed that the immediate and delayed groups differed significantly (p<0.05) in weight (−1.66 [SD=4.42] kg loss vs 0.05 [SD=4.15] kg gain) and moderate physical activity (52.93 [SD=90.74] minutes/week increase vs −14.22 [SD=96.02] minutes/week decrease), accounting for baseline weight, time with disability, and age of onset. The 12-month results with groups combined demonstrated 74.2% retention and 77.7% core session attendance. Self-monitoring was higher in the delayed group (77.3%), who used a smartphone app, than the immediate group (47.3%), who mostly used paper trackers. Participants achieved significant 12-month weight loss of 3.31 (SD=10.13) kg (d=0.33) in mixed modeling analyses with groups combined yet did not significantly increase moderate physical activity. Conclusions: Group Lifestyle Balance Adapted for Individuals with Impaired Mobility is a feasible, effective approach to teach healthy lifestyle skills to individuals with mobility impairment, yielding modest weight loss and enhanced self-efficacy. Trial registration: This study is registered at www.clinicaltrials.gov NCT03307187.
AB - Introduction: This study examines the feasibility and effectiveness of an intensive lifestyle intervention adapted for people with impaired mobility. Study design: This was a randomized, wait-list controlled trial. The experimental group immediately received the 12-month weight loss program; the wait-list control group received it after a 6-month delay. Between-group comparisons were conducted for the 6-month RCT study design. Repeated measures were conducted for both groups combined after receiving the 12-month intervention. Data were collected August 2015–February 2017 and analyzed in 2017. Setting/participants: A community-based sample received 23, group-based sessions via a mix of telephone and in-person sessions in a hospital-based setting. Participants with impaired mobility (n=66) were middle-aged (49.80 [SD=11.37] years), mostly White (66.7%), female (66.7%), and most commonly had spinal cord injury (47.0%). Intervention: The 12-month intervention delivered 23 group-based sessions that promoted weight loss through reducing caloric intake and increasing physical activity. Main outcome measures: Primary outcomes were effectiveness measured as change in weight and time spent in moderate physical activity. Feasibility was assessed in 12-month combined group analyses, measured as retention, attendance, and dietary self-monitoring. Results: The 6-month RCT results showed that the immediate and delayed groups differed significantly (p<0.05) in weight (−1.66 [SD=4.42] kg loss vs 0.05 [SD=4.15] kg gain) and moderate physical activity (52.93 [SD=90.74] minutes/week increase vs −14.22 [SD=96.02] minutes/week decrease), accounting for baseline weight, time with disability, and age of onset. The 12-month results with groups combined demonstrated 74.2% retention and 77.7% core session attendance. Self-monitoring was higher in the delayed group (77.3%), who used a smartphone app, than the immediate group (47.3%), who mostly used paper trackers. Participants achieved significant 12-month weight loss of 3.31 (SD=10.13) kg (d=0.33) in mixed modeling analyses with groups combined yet did not significantly increase moderate physical activity. Conclusions: Group Lifestyle Balance Adapted for Individuals with Impaired Mobility is a feasible, effective approach to teach healthy lifestyle skills to individuals with mobility impairment, yielding modest weight loss and enhanced self-efficacy. Trial registration: This study is registered at www.clinicaltrials.gov NCT03307187.
UR - http://www.scopus.com/inward/record.url?scp=85095803988&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2020.06.023
DO - 10.1016/j.amepre.2020.06.023
M3 - Article
C2 - 33160798
AN - SCOPUS:85095803988
SN - 0749-3797
VL - 59
SP - 805
EP - 817
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 6
ER -