Research article

Phone and e-mail counselling are effective for weight management in an overweight working population: a randomized controlled trial

Marieke F van Wier^1,2 , Geertje AM Ariëns^1,2,3 , J Caroline Dekkers^1,2,3 , Ingrid JM Hendriksen^2,4 , Tjabe Smid^1,5 and Willem van Mechelen^1,2

¹Department of Public and Occupational Health/EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands

²Body@Work, Research Center Physical Activity, Work and Health, TNO-VUmc, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands

³Municipal Health Service The Hague, PO Box 12652, 2500 DP The Hague, the Netherlands

⁴TNO Quality of Life, Wassenaarseweg 56, 2333 AL Leiden, the Netherlands

⁵KLM Health Services, PO Box 7700, 1117 ZL Schiphol Airport, the Netherlands

author email corresponding author email

BMC Public Health 2009, 9:6doi:10.1186/1471-2458-9-6

Published:	9 January 2009

Abstract

Background

The work setting provides an opportunity to introduce overweight (i.e., Body Mass Index ≥ 25 kg/m²) adults to a weight management programme, but new approaches are needed in this setting. The main purpose of this study was to investigate the effectiveness of lifestyle counselling by phone or e-mail on body weight, in an overweight working population. Secondary purposes were to establish effects on waist circumference and lifestyle behaviours, and to assess which communication method is the most effective.

Methods

A randomized controlled trial with three treatments: intervention materials with phone counselling (phone group); a web-based intervention with e-mail counselling (internet group); and usual care, i.e. lifestyle brochures (control group). The interventions used lifestyle modification and lasted a maximum of six months. Subjects were 1386 employees, recruited from seven companies (67% male; mean age 43 (SD 8.6) y; mean BMI 29.6 (SD 3.5) kg/m²). Body weight was measured by research personnel and by questionnaire. Secondary outcomes fat, fruit and vegetable intake, physical activity and waist circumference were assessed by questionnaire. Measurements were done at baseline and after six months. Missing body weight was multiply imputed.

Results

Body weight reduced 1.5 kg (95% CI -2.2;-0.8, p < 0.001) in the phone group and 0.6 kg (95% CI -1.3; -0.01, p = 0.045) in the internet group, compared with controls. In completers analyses, weight and waist circumference in the phone group were reduced with 1.6 kg (95% CI -2.2;-1.0, p < 0.001) and 1.9 cm (95% CI -2.7;-1.0, p < 0.001) respectively, fat intake decreased with 1 fatpoint (1 to 4 grams)/day (95% CI -1.7;-0.2, p = 0.01) and physical activity increased with 866 METminutes/week (95% CI 203;1530, p = 0.01), compared with controls. The internet intervention resulted in a weight loss of 1.1 kg (95% CI -1.7;-0.5, p < 0.001) and a reduction in waist circumference of 1.2 cm (95% CI -2.1;-0.4, p = 0.01), in comparison with usual care. The phone group appeared to have more and larger changes than the internet group, but comparisons revealed no significant differences.

Conclusion

Lifestyle counselling by phone and e-mail is effective for weight management in overweight employees and shows potential for use in the work setting.

Trial registration

ISCRTN04265725.