The transtheoretical model is an effective weight management intervention : a randomized controlled trial.
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Date
2020
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Abstract
Background: Given the current worldwide epidemic of obesity, there is a demand for interventions with higher
impact, such as those carried out in the primary health care (PHC) setting. Here we evaluate the effect of
intervention performed according to the stages of change of the transtheoretical model (TTM) for weight
management.
Methods: This randomized controlled trial in Brazilian PHC offered free physical exercise and nutrition education.
The participants were women, aged 20 years or older who were obese or overweight, users in PHC service. The
intervention group (IG, n = 51) received the same orientation as the comparison group (CG, n = 35) plus individual
health counseling based on the TTM aimed at weight loss, which lasted 6 months. The outcome measures were
anthropometric, food, and nutrient profiles. Inflammatory parameters were evaluated in a random subsample. The
inter-group and intra-group differences were evaluated using interntion-to-treat analysis, and analysis of covariance
(ANCOVA) used to assess intervention effectiveness.
Results: There was a difference between groups of − 1.4 kg (CI95%: − 2.5; − 0.3) in body weight after the
intervention. About 97% of women in the IG reported benefits of the intervention and presented positive changes
in diet, biochemical markers, and anthropometry. The IG showed better body mass index, resistine, and blood
glucose results compared to the CG during follow-up.
Conclusion: The individualized TTM-based intervention, combined with usual care, was an effective strategy in
PHC. These results should encourage the use of interdisciplinary practices; nevertheless, research to identify
additional strategies is needed to address barriers to weight maintenance among obese low-income women.
Trial registration: The trial is registered with Brazilian clinical trials under the code: RBR-8t7ssv, Registration date:
12/12/2017 (retrospectively registered).
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Keywords
Obesity, Primary health care, Feeding behavior, Intervention studies
Citation
FREITAS, P. P. de et al. The transtheoretical model is an effective weight management intervention : a randomized controlled trial. BMC Public Health, v. 20, artigo 652, 2020. Disponível em: <https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08796-1>. Acesso em: 11 out. 2022.