Ben Gerber*, University of Illinois at Chicago, Chicago, United States Linda Schiffer, University of Illinois at Chicago, Chicago, United States James Rimmer, University of Alabama at Birmingham, Birmingham, United States Carol Braunschweig, University of Illinois at Chicago, Chicago, United States Marian Fitzgibbon, University of Illinois at Chicago, Chicago, United States Track: Research Presentation Topic: Building virtual communities and social networking applications for patients and consumers Presentation Type: Rapid-Fire Presentation Submission Type: Single Presentation Building: Joseph B. Martin Conference Center at Harvard Medical School Room: A-Pechet Room Date: 2012-09-15 09:00 AM – 09:45 AM Last modified: 2012-09-10

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Objective: Long-term weight maintenance represents a challenge due to expected weight regain following weight loss efforts. This study evaluated the impact of home telehealth on weight maintenance following a church-based weight loss program designed for overweight African-American women.

Design: Eighty-eight African-American women were randomized to receive monthly telephone counseling (control) or telephone counseling plus home Internet-enabled digital video recorders (DVRs) for weekly video programs (intervention).

Methods: The video content provided reinforcement and support to promote problem solving, prevent relapse, and sustain motivation. We included three channels of video content for participant viewing. One channel was informational and dedicated to brief videos reinforcing healthy eating and physical activity. This channel included videos of the instructor (reminders, motivational talks, and problem solving ideas); cooking and grocery shopping; narrative stories from participants recorded during the weight loss maintenance phase; and other programs (e.g., SisterTalk, a health program targeting African-American women). The other two channels included exercise videos (beginning and advanced). In addition, e-mail and Listserv communication was available for interventionists, participants and research staff during the maintenance phase. Outcomes included weight, diet, physical activity, social support and self-efficacy related to diet and activity all measured at baseline, after a 3-month church-based weight loss program, and after a 9-month weight maintenance period.

Results: Overall mean weight change during the in-church program was -0.8 kg (95% confidence interval, CI, -1.4 kg to -0.2 kg). Following the 9-month maintenance period, both the telehealth and control groups regained weight, and there was no difference between groups in mean weight change from baseline (-0.4 vs. -0.6 kg, p=.82). Telehealth users reported a greater increase in fruit intake (0.7 vs. 0.3 servings/day) compared with control subjects. No differences were observed in social support or self-efficacy related to diet and physical activity between groups. Telehealth use for weight maintenance was low overall and positively associated with church weight loss class attendance. Seventeen (68%) of the 25 women who attended at least half of the classes used the DVR at least once, while only seven (35%) of the 20 women who attended less than half of the classes ever used the DVR (p=.03).

Conclusion: Home video-based telehealth represents a novel method of delivering a weight loss maintenance intervention to African-American women. Women who attended more church-based weight loss classes were also more likely to utilize home video later on during the maintenance period. However, non-usage attrition and barriers to weight maintenance remain challenges for telehealth use in obesity research.