Evaluating the maintenance of lifestyle changes in a randomized controlled trial of the 'Get Healthy, Stay Healthy' program

Fjeldsoe, Brianna S., Goode, Ana D., Phongsavan, Philayrath, Bauman, Adrian, Maher, Genevieve, Winkler, Elisabeth and Eakin, Elizabeth G. (2016) Evaluating the maintenance of lifestyle changes in a randomized controlled trial of the 'Get Healthy, Stay Healthy' program. JMIR Mhealth Uhealth, 4 2: e42.1-e42.13. doi:10.2196/mhealth.5280

Author Fjeldsoe, Brianna S.
Goode, Ana D.
Phongsavan, Philayrath
Bauman, Adrian
Maher, Genevieve
Winkler, Elisabeth
Eakin, Elizabeth G.
Title Evaluating the maintenance of lifestyle changes in a randomized controlled trial of the 'Get Healthy, Stay Healthy' program
Journal name JMIR Mhealth Uhealth   Check publisher's open access policy
ISSN 2291-5222
Publication date 2016-05-10
Sub-type Article (original research)
DOI 10.2196/mhealth.5280
Open Access Status DOI
Volume 4
Issue 2
Start page e42.1
End page e42.13
Total pages 13
Place of publication Toronto, ON, Canada
Publisher J M I R Publications
Collection year 2017
Language eng
Formatted abstract
Background: Extending contact with participants after initial, intensive intervention may support maintenance of weight loss
and related behaviors.

Objective: This community-wide trial evaluated a text message (short message service, SMS)-delivered, extended contact
intervention (‘Get Healthy, Stay Healthy’ (GHSH)), which followed on from a population-level, behavioral telephone coaching

Methods: This study employed a parallel, randomized controlled trial: GHSH compared with no continued contact (standard
practice). Participants (n=228) were recruited after completing a 6-month lifestyle telephone coaching program: mean age = 53.4
(standard deviation (SD)=12.3) years; 66.7% (152/228) female; mean body mass index (BMI) upon entering GHSH=29.5 kg/m2
(SD = 6.0). Participants received tailored text messages over a 6-month period. The message frequency, timing, and content of
the messages was based on participant preference, ascertained during two tailoring telephone calls. Primary outcomes of body
weight, waist circumference, physical activity (walking, moderate, and vigorous sessions/week), and dietary behaviors (fruit and
vegetable serves/day, cups of sweetened drinks per day, takeaway meals per week; fat, fiber and total indices from the Fat and
Fiber Behavior Questionnaire) were assessed via self-report before (baseline) and after (6-months) extended contact (with
moderate-vigorous physical activity (MVPA) also assessed via accelerometry).

Results: Significant intervention effects, all favoring the intervention group, were observed at 6-months for change in weight
(-1.35 kg, 95% confidence interval (CI): -2.24, -0.46, P=.003), weekly moderate physical activity sessions (0.56 sessions/week,
95% CI: 0.15, 0.96, P=.008) and accelerometer-assessed MVPA (24.16 minutes/week, 95% CI: 5.07, 43.25, P=.007). Waist
circumference, other physical activity outcomes and dietary outcomes, did not differ significantly between groups.

Conclusions: The GHSH extended care intervention led to significantly better anthropometric and physical activity outcomes
than standard practice (no contact). This evidence is useful for scaling up the delivery of GHSH as standard practice following
the population-level telephone coaching program.
Keyword Maintenance
Physical activity
Text message
Behavior change
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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Created: Fri, 13 May 2016, 15:48:29 EST by Genevieve Maher on behalf of School of Public Health