• Michael Lin, Zayan Mahmooth, Nicket Dedhia, Robin Frutchey, Catherine E Mercado, David H Epstein, Kenzie L Preston, Michael C Gibbons, Janice V Bowie, Alain B Labrique, and Lawrence J Cheskin.
• Johns Hopkins School of Medicine, Baltimore, Md.
• Am. J. Med. 2015 Aug 1; 128 (8): 896904896-904.

BackgroundHelping patients control obesity remains a clinical challenge for internists, and African Americans experience obesity rates higher than other racial/ethnic groups.PurposeTo investigate whether a behavioral theory-based mobile health intervention would enhance weight loss when added to standard care among overweight/obese African American adults.MethodsA randomized controlled trial of 124 adults recruited from Baltimore-area African American churches. Participant follow-up ended March 2013. Participants were randomized to standard care (included one-on-one counseling sessions with a dietitian and a physician) or standard care plus daily tailored text messages for 6 months. Text messages were delivered in phases: preparation, reinforcement of participant-selected diet and exercise goals, reflection, goal integration, weight loss methods, and maintenance. There were follow-up visits at 3, 6, and 12 months. Primary outcome was weight change from baseline to end-intervention at 6 months. Secondary outcomes included weight change at 3 months, engagement, and satisfaction with the intervention.ResultsSixty-three participants were randomized to the mobile health intervention and 61 to standard-care control. Weights were collected in-window for 45 (36.3%) at 3 months and 51 (41.1%) at 6 months. Mean weight loss at 3 months was 2.5 kg greater in the intervention group compared with standard care (95% confidence interval [CI], -4.3 to -0.6; P < .001), and 3.4 kg greater (95% CI, -5.2 to -1.7; P = .001) at 6 months. Degree of engagement with messages was correlated with weight loss.ConclusionsWhile attrition was high, this study supports a tailored, interactive text-message intervention to enhance weight loss among obese African-American adults.Copyright © 2015 Elsevier Inc. All rights reserved.

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