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Telehealth programs for long-term weight-loss maintenance have a differential impact on African Americans versus White adults.

Extended-care interventions after the end of initial weight-loss programs improve weight-loss maintenance. However, whether these interventions are equally effective for African American (AA) and White participants is unclear. A study in the Journal of Behavioral Medicine examined the effectiveness of extended-care telehealth programs against weight regain in AA versus White participants.

Study Population

The study comprised 410 adults, of whom 82 were AA and 328 were White, with a mean age of 55.59 years; 82% were female. The mean body mass index (BMI) was 36.44. Apart from the higher BMI of AA participants, there were no significant differences between the groups. After completing the Phase I weight-loss program, 140 participants (28 AA, 112 White) were randomized to receive individual telephone counseling, 127 (25 AA, 102 White) received group telephone counseling, and 143 (29 AA, 114 White) were randomized to the educational control condition.

African American Participants Showed Lower Weight Loss Than White Participants

The mean weight loss during Phase I was -8.46 kg, with no differences in weight loss by intervention group. However, there were significant differences in weight loss by race, with AA participants losing significantly less weight than the White participants (p<0.001).

Significant Differences by Race in the Effectiveness of Extended-Care Programs

The study demonstrated that there may be substantial differences by race in the effectiveness of extended-care programs, especially by modality. The participants regained a mean weight of 1.14 kg from months 4 to 16 (p<0.001). There was a significant impact of the treatment condition (p=0.003), with participants in the control condition experiencing a significant weight regain of 2.49 kg. In comparison, those in the individual and group conditions experienced a non-significant weight regain of 0.02 and 0.84 kg, respectively.

Race-Based Differences in Weight Regain

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Although the weight-regain difference was insignificant between AA and White participants, a condition by race interaction existed from months 4 to 16. During this period, White participants in the control group regained 3.31 and 1.72 kg more than white participants in the individual and group conditions, respectively. In contrast, the weight-regain difference between conditions among AA participants was non-significant. Moreover, AA participants in the individual condition regained 3.45 kg more than their White counterparts; however, the differences in weight regain between AA and White participants were not significant in the group or control conditions.   

Individual Condition Led to Higher Attendance and Better Program Adherence

Participants in the individual condition attended significantly more sessions than those in the group condition. The race did not significantly affect attendance. Participants in the individual condition also showed significantly better program adherence than those in the group or control conditions. AA participants showed significantly lower program adherence than White participants.

Source

O’Neal, L., Perri, M. G., Befort, C. A., Janicke, D. M., Shankar, M. N., Bauman, V., Daniels, M. J., Dhara, K., & Ross, K. M. (2022). Differential impact of telehealth extended-care programs for weight-loss maintenance in African American versus white adults. Journal of Behavioral Medicine, 45(4), 580–588. https://doi.org/10.1007/s10865-022-00291-9