Stepped Care for Weight Loss Maintenance

NCT ID: NCT06151145

Last Updated: 2025-05-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-01

Study Completion Date

2028-06-30

Brief Summary

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This study is a 3-group, parallel design, randomized controlled trial (RCT) in approximately 258 adults with obesity that will investigate whether a 16-week behavioral weight loss treatment and a 52-week stepped-care digital health intervention can improve the maintenance of a ≥ 5% weight loss.

16-week run-in (Phase 1). To qualify for randomization, participants must lose ≥ 5% of initial weight in the 16-week run-in. This loss will be achieved with the provision of weekly-group lifestyle counseling, which includes a partial meal replacement diet.

52-week randomized trial of 3 weight loss maintenance strategies (Phase 2): Participants who have achieved ≥ 5% weight loss during Phase 1 will be randomly assigned to 1 of 3 groups:

1. Participants in the Usual Care group will be emailed monthly educational modules with information on maintaining weight loss.
2. Participants in the SELF group will receive a wireless "smart" body weight scale and a wearable physical activity tracker, and daily text messages with tailored feedback to assist in weight loss maintenance.
3. Participants in the STEP group will be enrolled in an intervention that consists of 4 steps that are progressive and based on response to treatment. After 13 weeks at each step, participants who do not maintain a ≥5% weight loss or regain 2 percentage points of weight from the participants randomization value will move to a higher intensity step. Participants who maintain weight loss will stay at the same step.

Detailed Description

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Conditions

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Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Usual care

Usual care

Group Type ACTIVE_COMPARATOR

Usual care

Intervention Type BEHAVIORAL

Participants in usual care will be emailed monthly educational modules with information on maintaining weight loss.

Text-message intervention with digital tools (SELF)

Text-message intervention

Group Type EXPERIMENTAL

SELF

Intervention Type BEHAVIORAL

The SELF group will receive a wireless "smart" body weight scale and wearable physical activity tracker, and text messages.

Stepped Care (STEP)

Stepped care

Group Type EXPERIMENTAL

STEP

Intervention Type BEHAVIORAL

The STEP intervention consists of 4 steps that are progressive and based on response to treatment. Step 1: Digital health intervention. The first step will be the digital health intervention as described under SELF. Step 2: Monthly, in-person counseling. Participants who move to Step 2 will be provided with monthly, in-person counseling. Step 3: Twice per month counseling. Step 3 will be twice-monthly counseling, spaced at every other week. Step 4: Meal replacements. Participants will be prescribed a partial meal replacement program.

Interventions

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Usual care

Participants in usual care will be emailed monthly educational modules with information on maintaining weight loss.

Intervention Type BEHAVIORAL

SELF

The SELF group will receive a wireless "smart" body weight scale and wearable physical activity tracker, and text messages.

Intervention Type BEHAVIORAL

STEP

The STEP intervention consists of 4 steps that are progressive and based on response to treatment. Step 1: Digital health intervention. The first step will be the digital health intervention as described under SELF. Step 2: Monthly, in-person counseling. Participants who move to Step 2 will be provided with monthly, in-person counseling. Step 3: Twice per month counseling. Step 3 will be twice-monthly counseling, spaced at every other week. Step 4: Meal replacements. Participants will be prescribed a partial meal replacement program.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* BMI\>/=30 kg/m2 or \>/=27 kg/m2 with an obesity-related complication
* Age 18-70 years
* Completion of baseline assessment tasks
* Ability to engage in physical activity
* Own a smartphone capable of receiving text-messages and syncing to weight scales and physical activity trackers
* Home wireless access

Exclusion Criteria

* Serious medical condition or psychiatric condition that may pose a risk to the participant during intervention, cause a change in weight, or limit ability to adhere to the behavioral recommendations of the program
* Pregnant or planning pregnancy in the next 1.5 years
* Weight\>440 lbs
* Planned move out of the area in the next 1.5 years
* Recently began a course of or changed the dosage of medication that can cause significant change in weight
* History of bariatric surgery
* Weight loss of \>5% in the previous 6 months
* Household member already participating in study
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Nursing Research (NINR)

NIH

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ariana M Chao, PhD, CRNP

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins University

Locations

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Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ariana M Chao, PhD, CRNP

Role: CONTACT

4432876223

Facility Contacts

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Camille Siberine

Role: primary

667-306-9366

Other Identifiers

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R01NR020197

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00404188

Identifier Type: -

Identifier Source: org_study_id

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