Rural Engagement in Primary Care for Optimizing Weight Reduction

Nearly 20% of the U.S. population lives in rural communities. Rural residents suffer at a
higher rate from obesity and obesity-related illnesses, including diabetes, heart disease,
and arthritis. Local primary care physicians are an important resource for treating obesity
in rural areas because of a lack of other community resources.

This study is looking at how effective current, real-world primary care treatment models are
in helping rural residents lose weight and maintain that weight loss. Physician clinics will
be randomized (like picking numbers from a hat) to conduct one of the three methods. The
method a participant is part of will depend on the method their physician's clinic is
randomized to. The three methods involved in this study are:

1. Individual weight-management counseling in person

2. Group weight-management counseling, both in person and by telephone

3. Group weight-management counseling by telephone

Participants will be in the study about 24 months. The number of in-person clinic visits and
phone calls each participant will be asked to complete depends on the method.

Inclusion Criteria:

- BMI between 30 kg/m2 and 45 kg/m2

- Live in a rural location

- Have clearance from their primary care provider to participate in a diet and exercise
weight control intervention

- Participants must have access to a telephone

- One individual per household will be permitted to enroll in the study

Exclusion Criteria:

- History of heart attack, stroke, new cancer diagnosis, bariatric surgery

- Pregnancy planned within the next two years or currently pregnant or lactating

- Serious medical conditions where weight loss is contraindicated

- Medical contraindications will be determined by the patient's primary care physician
(PCP), and documented PCP clearance will be obtained

- Participants who are already enrolled in, or planning to enroll in another research
study where weight loss is targeted

- Participants who plan to relocate outside of their provider's service area or who plan
to leave their primary care clinic in the next 2 years

- Able to read and understand English