Racial and ethnic minority enrollment in randomized clinical trials of behavioural weight loss utilizing technology: a systematic review

Rosenbaum, Diane L.; Piers, Amani D.; Schumacher, Leah M.; Kase, Colleen A.; Butryn, Meghan L.

doi:10.1111/obr.12545

Cited by 36 publications

(36 citation statements)

References 102 publications

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“…With the rapid evolution of digital health devices and platforms, offering choices between modalities likely enhances convenience and flexibility and has been shown to promote engagement (90). Further, recent years have seen changing preferences toward accessing the Internet via a smartphone rather than a personal computer, particularly among Hispanic and Black adults, individuals residing in rural areas, and lower‐income populations (91)—groups who all have heightened obesity risk (15,92) and yet are traditionally underrepresented in obesity treatment (93). To address these changing attitudes and broaden the reach of behavioral obesity treatment, interventionists should leverage mobile platforms for self‐monitoring.…”

Section: Discussionmentioning

confidence: 99%

Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

Patel

Wakayama

Bennett

2021

Obesity

120

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Objective: Self-monitoring is a core component of behavioral obesity treatment, but it is unknown how digital health has been used for selfmonitoring, what engagement rates are achieved in these interventions, and how self-monitoring and weight loss are related. Methods: This systematic review examined digital self-monitoring in behavioral weight loss interventions among adults with overweight or obesity. Six databases (PubMed, Embase, Scopus, PsycInfo, CINAHL, and ProQuest Dissertations & Theses) were searched for randomized controlled trials with interventions ≥ 12 weeks, weight outcomes ≥ 6 months, and outcomes on self-monitoring engagement and their relationship to weight loss. Results: Thirty-nine studies from 2009 to 2019 met inclusion criteria. Among the 67 interventions with digital self-monitoring, weight was tracked in 72% of them, diet in 81%, and physical activity in 82%. Websites were the most common self-monitoring modality, followed by mobile applications, wearables, electronic scales, and, finally, text messaging. Few interventions had digital self-monitoring engagement rates ≥ 75% of days. Rates were higher in digital-than in paper-based arms in 21 out of 34 comparisons and lower in just 2. Interventions with counseling had similar rates to standalone interventions. Greater digital self-monitoring was linked to weight loss in 74% of occurrences. Conclusions: Self-monitoring via digital health is consistently associated with weight loss in behavioral obesity treatment.

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Section: Discussionmentioning

confidence: 99%

Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

Patel

Wakayama

Bennett

2021

Obesity

120

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“…Further, the use of technology to both recruit and deliver behavioral weight loss interventions shows promise for increasing inclusion of diverse samples. A recent review found that weight loss trials that incorporated smartphone use had greater enrollment of racial/ethnic minority participants than trials that did not incorporate smartphones ( Rosenbaum et al, 2017 ). Emerging studies are revealing that interventions delivered via online programs ( Sepah et al, 2015 ) and online social networks are effective at producing weight loss in the absence of clinic visits ( Pagoto et al, 2015 ; Turner-McGrievy and Tate, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review

Haughton

Silfee

Wang

et al. 2018

Preventive Medicine Reports

137

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Obesity remains a persistent public health and health disparity concern in the United States. Eliminating health disparities, particularly among racial/ethnic minority groups, is a major health priority in the US. The primary aim of this review was to evaluate representation of racial/ethnic sub-group members in behavioral weight loss interventions conducted among adults in the United States. The secondary aims were to assess recruitment and study design approaches to include racial/ethnic groups and the extent of racial/ethnic sub-group analyses conducted in these studies. PubMed, PsycInfo, Medline, and CINAHL were searched for behavioral weight loss intervention trials conducted in 2009–2015 using keywords: weight, loss, overweight, obese, intervention and trial. Most of the 94 studies included a majority of White participants compared to any other racial/ethnic group. Across the included studies, 58.9% of participants were White, 18.2% were African American, 8.7% were Hispanic/Latino, 5.0% were Asian and 1.0% were Native Americans. An additional 8.2% were categorized as “Other”. Nine of the 94 studies exclusively included minority samples. Lack of adequate representation of racial and ethnic minority populations in behavioral trials limits the generalizability and potential public health impact of these interventions to groups that might most benefit from weight loss. Given racial/ethnic disparities in obesity rates and the burden of obesity and obesity-related diseases among minority groups in the United States, greater inclusion in weight loss intervention studies is warranted.

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“…However, most areas of research have groups that are underrepresented. Within the area of behavioral weight control, samples are predominately female [2][3][4][5] and non-Hispanic White [5,6].…”

Section: Introductionmentioning

confidence: 99%

Using targeting to recruit men and women of color into a behavioral weight loss trial

Crane

Seburg

Levy

et al. 2020

Trials

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Background: The majority of participants in weight loss trials are non-Hispanic White women, while men and women of color are underrepresented. This study presents data obtained from non-targeted and targeted recruitment approaches in a trial of behavioral weight loss programs to (1) describe the yields from each approach and (2) compare the demographics, weight control histories, and study involvement of samples recruited by each approach. Methods: Data for this observational study include source of recruitment, demographic information, weight loss experiences (e.g., lifetime weight loss, current weight loss behaviors), and completion of the 6-month assessment visit. Results: Men comprised 14.2% of participants who responded to non-targeted recruitment efforts, while targeted efforts yielded 50.4% men. Similarly, people of color comprised 12.8% of those who responded to non-targeted approaches, whereas targeted recruitment methods yielded 47.2% people of color. Men recruited through targeted methods were younger (p = 0.01) than men recruited through non-targeted means but were otherwise similar. Women of color recruited through targeted methods reported use of fewer weight loss strategies relative to women of color recruited through non-targeted means (p = 0.006) but were otherwise similar. There were no differences by recruitment method on retention to the study. Conclusions: Using targeted recruitment methods increased the ethnic and gender diversity of the recruited sample without reducing study retention. This targeting also increased the enrollment of women with less weight loss experience who may not have otherwise sought out a weight loss program. Developing and implementing a targeted recruitment plan should be considered early in the clinical trial development process.

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Racial and ethnic minority enrollment in randomized clinical trials of behavioural weight loss utilizing technology: a systematic review

Cited by 36 publications

References 102 publications

Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity

Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review

Using targeting to recruit men and women of color into a behavioral weight loss trial

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