Obesity: Technology-Supported Multicomponent Coaching or Counseling Interventions To Reduce Weight
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends multicomponent interventions that use technology-supported coaching or counseling to help clients lose weight.
The CPSTF also recommends this type of intervention to maintain weight loss.
The full CPSTF Finding and Rationale Statement and supporting documents for Obesity Prevention and Control: Technology-Supported Multicomponent Coaching or Counseling Interventions to Reduce Weight are available in The Community Guide Collection on CDC Stacks.
Intervention
In these interventions, coaches or counselors use technology to communicate with individuals or groups and help them lose weight. Such technologies may include computers, video conferencing, personal digital assistants, pedometers with computer interaction, or mobile applications. Interventions may be used with additional components such as tracking and monitoring, social interaction, in-person counseling, or education.
About The Systematic Review
The CPSTF finding is based on evidence from a systematic review of 14 studies (search period 1966-June 2008).
Study Characteristics
- Studies included randomized controlled trials (13 studies), and one before-and-after study design. Comparison groups, however, were exposed to a variety of treatment conditions
- Studies were conducted in the U.S. (12 studies), U.S. and Canada (1 study), and Taiwan (1 study)
- The primary purpose for interventions included weight loss (10 studies) and diabetes management (4 studies)
- Studies targeted adults (13 studies) and children and adolescents (1 study)
Summary of Results
Fourteen studies were included in the systematic review.
Weight loss
- All of the studies reported weight loss with a median decrease of 8.1 lbs (3.7 kgs) over a median follow-up time of 6 months (13 studies)
Physical activity
- Most of the studies reported an increase in physical activity (5 of 7 studies)
Nutrition
- All of the studies showed small decreases in caloric and fat intake (7 studies)
Summary of Economic Evidence
Two studies were included in the economic review. Monetary values are presented in 2009 U.S. dollars.
- One study evaluated a 6-month, Internet-based program that used case management to assist patients with cardiac rehabilitation and risk factor reduction
- The estimated cost for the program was $528 per participant
- Net savings from the intervention were $1125/person, for an estimated return of $2.13 for every $1.00 spent
- Another study evaluated an Internet-based weight loss program in Sweden
- The cost-effectiveness for participants who stayed in the program for 6 months was $0.49/pound lost
- A large number of participants dropped out of the study or had incomplete data. When these participants were included in the analysis, the cost-effectiveness of the program increased to $2.45/pound lost
Applicability
Findings of the review should be applicable to the following:
- Adults
- Home and community settings
- U.S.
- Interventions delivered by counselors and other types of healthcare providers
- Assorted technologies (e.g., websites, email, interactive TV modalities)
Evidence Gaps
- Does the type of technology and whether it is mobile make a difference?
- Are technology-based interventions as effective across subpopulations? Does effectiveness vary by age, cultural, SES, sex, race, or ethnicity?
- Does effectiveness vary based on an interaction between subpopulations (e.g., cultural, age) and type of technology (e.g. computer, mobile device)?
- How does provider training or credentialing affect services to clients?
- Are clients and providers more likely to engage if technical support or training on computer applications are provided?
Implementation Considerations and Resources
- Technology-supported counseling may offer increased access for people living in remote areas, people who cannot travel easily, or people with unusual work schedules. It also allows anonymity for those who prefer it and can be available 24 hours a day.
- Developing technology-supported interventions requires an initial investment in computer hardware, software, and application design.
- Participants will need access to a computer or other technology.
- Practitioners and participants may require training with new technology.
- It may be difficult to keep up with rapid changes in technology (data security).
Crosswalks
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.