University of Virginia School of Medicine public health researchers, together with colleagues at the University of South Carolina, have received a $3.37 million grant from the National Institutes of Health to determine if online behavioral weight-management programs for rural residents can be improved by adding a human touch.

Online obesity programs have typically failed to yield the same benefits as in-person programs, the researchers note, so they will test three approaches to add human involvement. More than 600 volunteer participants will be enrolled in a core online 24-week weight-loss program and randomly assigned to receive one of two forms of feedback on their self-monitoring efforts, as well as potentially receiving additional components including weekly group video sessions and individual coaching calls.

The goal is to help residents of rural areas, where in-person weight-loss programs can be scarce, manage their weight and fight the obesity epidemic that has swept America.

Weight loss of as little as 5% to 7% can reduce obesity-associated co-morbidities. Although lifestyle interventions successfully produce weight losses of this magnitude, access to weight management programs is limited in rural areas. This study will examine how digital interventions can be optimized for delivering weight loss programs to rural populations.”

Becca Krukowski, PhD, UVA public health researcher, one of the principal investigators

The obesity epidemic

More than 130 million Americans are overweight or obese, and people living in rural areas experience significantly higher rates of both obesity and chronic illnesses associated with obesity. Many rural areas are also beset by an increasing lack of access to healthcare resources. So finding better ways to help rural residents manage their weight could have big benefits for both individuals and society. That type of ambitious goal to improve the health of people across Virginia and beyond aligns closely with UVA Health’s first-ever 10-year strategic plan, which aims to transform healthcare by finding innovative ways to help people live longer, healthier lives.

Krukowski, of UVA’s Department of Public Health Sciences, notes that there is already some evidence that adding a human component to digital obesity-treatment programs can improve their effectiveness. She hopes her new trial will offer answers on the best “package” of treatment components.

Over the next three years, she and her collaborators will enroll and provide the iREACH program for a total of 616 men and women, with the goal of determining which approach, or which combination of approaches, is most effective at promoting weight loss and subsequent weight maintenance. They will look at factors that contribute to weight loss success, such as social support, accountability and problem solving. They will also consider elements such as sex, race/ethnicity and age, as well as the costs of the intervention components.

The iREACH program has just started recruiting for the first wave, which will start right after the new year – perfect timing for New Year’s resolutions related to improving health.

Improving America’s health

Ultimately, Krukowski and her team hope their research will lead to optimized online weight-loss programs that will be more accessible to rural residents than in-person programs. That would increase the public-health benefits of the programs and will inform public health policy decisions such as whether the programs should be covered by Medicare, Medicaid and other health insurance companies.

“The iREACH study is an exciting opportunity for rural residents to have access to a cutting-edge behavioral weight loss program and also contribute to science,” Krukowski said.

The trial is IRB No. HSR220408. For more information, visit https://www.ireachstudy.org/ or call 1-866-271-7217.

The five-year NIH grant, from the National Institute of Diabetes and Digestive and Kidney Diseases, is No. R01DK135227.