Objective: Evaluate effectiveness of weight-loss interventions in a managed care setting. Methods: Three-arm randomized clinical trial: usual care, mail, and phone intervention. Participants were 1801 overweight managed care organization (MCO) members. Measures included baseline height, weight at baseline and 24 months, self-reported weight at 18 months. Intervention and participation in other weight-related programs was monitored across 24 months. Results: Weight losses were 2.2, 2.4, and 1.9 kg at 18 months in the mail, phone, and usual care groups, respectively. Mail and phone group weight changes were not significantly different from usual care (P<0.35).Weight losses at 24 months did not differ by condition (0.7 kg mail, 1.0 kg phone, and 0.6 kg usual care, P=0.55). Despite treatment availability over 24 months, participation diminished after 6 months. Participation was a significant predictor of outcomes in the mail and phone groups at 18 months and the mail group at 24 months. Cost-effectiveness of phone counseling was $132 per 1 kg of weight loss with mail and usual care achieving similar cost-efficiency of $72 per 1 kg of weight loss. Conclusion: Although mail- and phone-based weight-loss programs are a reasonably efficient way to deliver weight-loss services, additional work is needed to enhance their short- and long-term efficacy.
Bibliographical noteFunding Information:
1HealthPartners Research Foundation, Minneapolis, MN, USA; 2Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, MN, USA and 3HealthPartners Center for Health Promotion, Minneapolis, MN, USA
This project was a collaboration among the University of Minnesota School of Public Health, the HealthPartners Research Foundation, and the HealthPartners Center for Health Promotion (CHP). Study recruitment began in August 1999 and data collection was completed for all study participants in October 2002. HealthPartners is a mixed-model managed care organization (MCO) that provides medical care service for approximately 700 000 members in the Minneapolis/St Paul, Minnesota metropolitan area. The study was a randomized trial evaluating the effectiveness of phone-based and mail-based interventions for weight reduction offered to members in comparison to usual care over 2-years. Recruitment targeted overweight MCO members from four clinics. Two clinics served members in St Paul and Minneapolis and two served individuals in adjacent suburbs.
- Managed care
- Weight loss