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Catch It Report: - Web based weight loss RCT
1. CATCH-IT Report Bennett GG, Herring SJ, Puleo E, Stein EK, Emmons KM, and Gillman MW. Web-based Weight Loss in Primary Care: A Randomized Controlled Trial. Obesity (2009) doi:10.1038/oby.2009.242 November 16, 2009
12. Reference 19 Burt C, McCaig L, Rechtsteiner E . Ambulatory medical care utilization estimates for 2005. Advance data from vital and health statistics. Hyattsville, MD: National Center for Health Statistics, 2007 < http://www.cdc.gov/nchs/data/ad/ad388.pdf >.
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18. Participant Flow Baseline assessment Follow-up assessment Research staff collecting evaluation data blinded to randomization status predetermined assignments enclosed in non-transparent randomization envelopes) Dates, setting, informed consent, blinding (participant, care provider) ?? unclear
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20. Reference 20 NHANES Food Questionnaire Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Questionnaire. Hyattsville, MD, 2004 < http://www.cdc.gov/nchs/data/nhanes/nhanes_03_04/tq_fpq_c.pdf >
21. Intervention vs Usual Care 84% of intervention 84% of usual care Aim for Healthy Weight material Web-based behaviour treatment + health coach ??
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23. Figure 1 W ebsite-based tracking system screenshot
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31. Primary Outcome Weight loss by condition in the Step Up Trim Down weight loss trial ( n = 101) Suggestion to include % weight loss 25.6% of intervention participants lost >5% body weight by week 12 (none in control)
32. Secondary outcome -0.38 mm Hg (95% CI -4.03, 3.27) diastolic blood pressure -1.30 mm Hg (95% CI -3.38, 5.99) systolic blood pressure -1.87 cm (95% CI -3.97, 0.23) waist circumference -1.07 kg/m2 (95% CI -1.49, -0.64) BMI Mean Difference (Intervention versus Usual Care)
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34. Association between frequency of website logins and weight loss (20.99-2 =18.99) (50.49-21=29.49) (71.99-50.50=21.49) (130-72=58.0) 0 – 2 missing? Data intervals not proportional
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40. Public health approach to prevent obesity effectiveness of programs for weight loss via lifestyle change (controlled energy intake, increased physical activity) is highly variable and infrequent result in sustainable weight loss
Long term weight loss difficult to achieve Multiple interventions needed including Behaviour therapy Small weight reductions (5% to 10%) associated with health benefits
Burt C, McCaig L, Rechtsteiner E . Ambulatory medical care utilization estimates for 2005. Advance data from vital and health statistics. Hyattsville, MD: National Center for Health Statistics, 2007 < http://www.cdc.gov.myaccess.library.utoronto.ca/nchs/data/ad/ad388.pdf >.
Declaration of helsinki and approved by relevant human subjects review committee blinding (participant, individual;provider, analysis) 5 Dates, setting
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. Regular self-monitoring has been consistently demonstrated as an effective behavior change strategy (23), however, adherence wanes over time. To overcome adherence challenges, we created a dynamic, graphically rich, high usability self-monitoring tool that permitted tracking of individual progress and displayed the average performance for other program participants (see Figure 1 ).
We chose self-monitoring metrics that would limit complexity, relying primarily on dichotomous response options.
Participants randomized to the web-based intervention would demonstrate greater weight losses compared to those in usual care
We observed a larger reduction in BMI among intervention participants), relative to those randomized to usual care; mean difference:). We did not find any group differences for change in (mean difference), (mean difference:), or (mean difference:). We observed no gender differences in change for any of the body weight or secondary outcomes.
Majority of intervention participants met the website login goal through week 9 Over 40% continued to meet the login goal through week 12.
Figure 3 shows the association between website login quartile and weight loss in the intervention group ( P for trend = 0.0007). Compared to the lowest quartile of website logins, those in the highest quartile showed greater weight loss (mean difference:-4.16 kg; 95% CI -1.47, -6.84). Differences in weight loss were also observed between quartiles two and four (mean difference: -4.87; 95% CI -2.56, -7.17).
Importance of research question, originality of research, validity
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