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Variability in engagement and progress in efficacious integrated collaborative care for primary care patients with obesity and depression: Within-treatment analysis in the RAINBOW trial

Author

Listed:
  • Nan Lv
  • Lan Xiao
  • Marzieh Majd
  • Philip W Lavori
  • Joshua M Smyth
  • Lisa G Rosas
  • Elizabeth M Venditti
  • Mark B Snowden
  • Megan A Lewis
  • Elizabeth Ward
  • Lenard Lesser
  • Leanne M Williams
  • Kristen M J Azar
  • Jun Ma

Abstract

Introduction: The RAINBOW randomized clinical trial validated the efficacy of an integrated collaborative care intervention for obesity and depression in primary care, although the effect was modest. To inform intervention optimization, this study investigated within-treatment variability in participant engagement and progress. Methods: Data were collected in 2014–2017 and analyzed post hoc in 2018. Cluster analysis evaluated patterns of change in weekly self-monitored weight from week 6 up to week 52 and depression scores on the Patient Health Questionnaire-9 (PHQ-9) from up to 15 individual sessions during the 12-month intervention. Chi-square tests and ANOVA compared weight loss and depression outcomes objectively measured by blinded assessors to validate differences among categories of treatment engagement and progress defined based on cluster analysis results. Results: Among 204 intervention participants (50.9 [SD, 12.2] years, 71% female, 72% non-Hispanic White, BMI 36.7 [6.9], PHQ-9 14.1 [3.2]), 31% (n = 63) had poor engagement, on average completing self-monitored weight in

Suggested Citation

  • Nan Lv & Lan Xiao & Marzieh Majd & Philip W Lavori & Joshua M Smyth & Lisa G Rosas & Elizabeth M Venditti & Mark B Snowden & Megan A Lewis & Elizabeth Ward & Lenard Lesser & Leanne M Williams & Kriste, 2020. "Variability in engagement and progress in efficacious integrated collaborative care for primary care patients with obesity and depression: Within-treatment analysis in the RAINBOW trial," PLOS ONE, Public Library of Science, vol. 15(4), pages 1-16, April.
    • Handle: RePEc:plo:pone00:0231743
    DOI: 10.1371/journal.pone.0231743
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