Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity

We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology.

Participants video-called with registered dietician nutritionists, were guided by a physical therapist in exercise through a tablet device, and wore a Fitbit. On average, participants lost weight, improved their 30 second sit-to-stand, and at least 41% of participants had at least a 30 meter improvement in 6-min walk. Subjective measures of Late-life function and disability instrument (LLFDI) also noted improvements in total, upper, basic lower, and advanced lower extremity function. In conclusion, this technology-based, video-monitoring and remote monitoring intervention is feasible, acceptable, and demonstrates favorable outcomes by overcoming the limitations of existing geriatric weight-loss trials, overcoming a need for proximity to medical facilities.

John A. Batsis, Curtis L. Petersen, Matthew M. Clark, Summer B. Cook, David Kotz, Tyler L. Gooding, Meredith N. Roderka, Rima I. Al-Nimr, Dawna Pidgeon, Ann Haedrich, K.C. Wright, Christina Aquila, and Todd A. Mackenzie. Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity. BMC Geriatrics, volume 21, article 44, 13 pages. BMC, January 2021. doi:10.1186/s12877-020-01978-x. PMID: 33435877.

Willingness to pay for a telemedicine-delivered healthy lifestyle programme

Recent Amulet paper:

Effective weight-management interventions require frequent interactions with specialised multidisciplinary teams of medical, nutritional and behavioural experts. However, barriers that exist in rural areas, such as transportation and a lack of specialised services, can prevent patients from receiving quality care. We recruited patients from the Dartmouth-Hitchcock Weight & Wellness Center into a single-arm, non-randomised study of a remotely delivered 16-week evidence-based healthy lifestyle programme. Every 4 weeks, participants completed surveys that included their willingness to pay for services like those experienced in the intervention based on commute and copay. Overall, those with a travel duration of 31–45 min had a greater willingness to trade in-person visits for telehealth than any other group. Participants who had a travel duration less than 15 min, 16–30 min and 46–60 min experienced a positive trend in willingness to have telehealth visits until Week 8, where there was a general negative trend in willingness to trade in-person visits for virtual. Participants believed that telemedicine was useful and helpful. In rural areas where patients travel 30–45 min a telemedicine-delivered, intensive weight-loss intervention may be a well-received and cost-effective way for both patients and the clinical care team to connect.

Vanessa K. Rauch, Meredith Roderka, Auden C. McClure, Aaron B. Weintraub, Kevin Curtis, David F. Kotz, Richard I. Rothstein, and John A. Batsis. Willingness to pay for a telemedicine-delivered healthy lifestyle programmeJournal of Telemedicine and Telecare, June 2020. Sage. DOI: 10.1177/1357633X20943337