Family-Based Interventions to Promote Weight Management in Adults: Results From a Cluster Randomized Controlled Trial in India.

BACKGROUND

We evaluated the effectiveness of a structured family-based cardiovascular health promotion intervention model in improving weight management among adults.

METHODS

We conducted an open label, cluster randomized controlled trial (ClinicalTrials.gov NCT02771873) with families serving as the unit of intervention. Families were randomly assigned via computer-generated numbers to receive either the comprehensive package of interventions or enhanced usual care in a 1:1 ratio. Nonphysician health workers delivered the comprehensive package of interventions, which included annual screening for cardiovascular risk factors, structured lifestyle modification sessions, referral to a primary health care facility for individuals with established risk factors, and active follow-up to evaluate self-care adherence. Weight, body mass index (BMI), and waist circumference were measured at baseline, 1 year, and 2 years to assess the intervention's effect on weight management. We used a generalized estimating equation model to analyze the between-group population average changes in these anthropometric parameters.

RESULTS

In total, 1,671 participants (1,111 women) from 750 families participated. The mean age of the study population was 40.8 (SD = 14.2) years. The attrition rate at the 2-year follow-up was 3%. The adjusted population average change attributable to the intervention at the 2-year follow-up were -2.61 kg in weight (95% CI, -3.95 to -1.26; P <.001), -1.06 kg/m2 in BMI (95% CI, -1.55 to -0.58; P <.001), and -4.17 cm in waist circumference (95% CI, -5.38 to -2.96; P <.001).

CONCLUSION

The reduction in weight achieved in the family-based intervention could have a substantial public health impact in preventing future diabetes and other noncommunicable disease conditions.