Schedules Of Extended Care Group Counseling For Weight Loss Maintenance: Results Of A Randomized Controlled Pilot Trial

Knee osteoarthritis (KOA) represents a leading cause of mobility disability for older adults in the U.S. Body weight is a primary modifiable risk factor. Thus, lifestyle intervention represents an integral component of disease management efforts. However, following primary behavioral intervention, significant weight regain is common. PURPOSE: To determine the feasibility and preliminary efficacy of online extended care group counseling contacts for attenuating weight regain and enhancing physical activity and function in older KOA patients after primary intervention. METHODS: This 6-month, two-arm, randomized controlled pilot trial examined two schedules of online, group counseling contacts in a subsample of participants who completed an intensive 12-month multi-component lifestyle intervention, and a subsequent 6-month no contact period (n = 32; age = 66.2 ± 6.1 years). Participants received 6 additional group counseling contacts via traditional monthly (TRAD; n = 16), or two, 3-week clusters of contacts (CLUS; n = 16). Primary and exploratory outcomes included body composition (DXA) and physical activity (activPAL), and mobility performance (400 m walk time), respectively. RESULTS: Recruitment (62.7%), retention (96.9%), and adherence (89%) rates were high. No significant between-group differences were observed in weight loss maintained, change in body composition, step count, sitting time, or mobility performance. Immediately following the initial 12-month intensive intervention, participants regained 1.87 kg on average. Whereas, the average amount of weight change during extended care was -0.08 ± 3.40 kg between groups. Notably, both the TRAD and CLUS groups maintained body weight significantly better than they had during the previous 6-month no contact period (net -1.95 kg; p = .016). CONCLUSIONS: This is the first study to compare alternative evidence-based, theory-guided sequences of online, extended care group weight management counseling contacts in older KOA patients following completion of primary treatment. Cumulative results will inform the future design and delivery of a fully-powered long-term weight maintenance trial.