Telemedical coaching for weight loss in overweight employees: a three-armed randomised controlled trial.
OBJECTIVES
We examined the effect of a telemedical coaching (TMC) programme accompanied with or without telemonitoring on weight loss in an occupational healthcare setting with a three-armed randomised controlled trial (NCT01837134 'Pre-results').


METHODS
Overweight employees (n=104, body mass index [BMI] ≥25 kg/m2) were invited by their medical corporate department and randomised into either a TMC group (n=34) or in one of the two control groups (C1, n=34; C2, n=36). TMC and C1 were equipped with telemonitoring devices (scales and pedometers) at baseline, and C2 after 6 months. Telemonitoring devices automatically transferred data into a personalised online portal. TMC was coached with weekly care calls in months 3-6 and monthly calls from months 7 to 12. C2 had a short coaching phase in months 6-9. C1 received no further support. After the 12-month intervention phase, participants could take advantage of further company health promotion offers. Follow-up data were determined after 12 months of intervention and per-protocol (PP) and intention-to-treat (ITT) analyses were performed. Weight change was followed up after 36 months. Estimated treatment difference (ETD) was calculated for weight reduction.


RESULTS
ETD from TMC to C1 (-3.6 kg 95% CI -7.40 to -0.1, p=0.047) and to C2 (-4.2 kg [-7.90 to -0.5], p=0.026) was significantly different at the 12 months follow-up in the PP-analysis, but lost significance in the ITT analysis. All groups reduced weight after 12 months (-3.3 to -8.4 kg [5.5-10.3 kg], all p<0.01) and sustained it during the 36 months follow-up (-4.8 to -7.8 kg [5.6-12.8 kg], all p<0.01). ETD analyses revealed no difference between all groups neither in the PP nor in the ITT analysis at the 3 years follow-up. All groups reduced BMI, systolic and diastolic blood pressure and improved eating behaviour in the PP or ITT analyses.


CONCLUSIONS
TMC and/or telemonitoring support long-term weight reduction in overweight employees. The combination of both interventions points towards an additional effect.


TRIAL REGISTRATION NUMBER
NCT01837134.
['Kempf|Kerstin|K|0000-0003-4285-3127', 'Röhling|Martin|M|0000-0002-2258-0582', 'Martin|Stephan|S|', 'Schneider|Michael|M|']
D000328:Adult D001794:Blood Pressure D015992:Body Mass Index D015444:Exercise D005247:Feeding Behavior D005260:Female D005858:Germany D006801:Humans D016014:Linear Models D008297:Male D000071252:Mentoring D008875:Middle Aged D016272:Occupational Health D050177:Overweight D017216:Telemedicine D015431:Weight Loss D061217:Weight Reduction Programs
preventive medicine public health telemedicine