1. Introduction
obesity, cancer, overweight, ±
OBESITY, CANCER, OBESE, CHRONIC DISEASES
These authors contributed equally to this work.Rural residents experience higher rates of obesity, obesity-related chronic diseases, and poorer lifestyle. Promoting physical activity and healthy eating are critical for rural residents; however, lack of resources and access barriers limit the feasibility of in-person lifestyle interventions. There is a need to design and deliver remotely accessible lifestyle interventions in this population. This pilot study examined the effect of a telephone-based lifestyle intervention on weight, body composition, lipids, and inflammatory biomarkers among rural Ohio residents. Rural Ohio adults with overweight/obesity (n = 40) were 2:1 randomized to a 15-week telephone-based lifestyle intervention (n = 27) or control group (n = 13). The lifestyle intervention group received weekly telephone counseling sessions emphasizing healthy eating and increasing physical activity. The control group received educational brochures describing physical activity and dietary recommendations. Weight, body composition, fasting blood lipids, and inflammatory biomarkers were objectively measured at baseline and 15 weeks at local community centers (trial registration#: NCT05040152 at ClinicalTrial.gov). Linear mixed models were used to examine change over time by group. Participants were mostly female, with an average age of 49 years. Over the 15-week trial, the lifestyle intervention showed superior improvements in total cholesterol (∆ = −18.7 ± 7.8 mg/dL, In the United States, about one in five people live in a designated rural area [The factors contributing to rural health disparities are complex. Evidence suggests that individuals in rural areas engage in more disease-risk behaviors including physical inactivity, unhealthy diet, and lower rates of vaccination and cancer screening [Indeed, although the effectiveness of lifestyle weight management interventions has long been established, studies have primarily been conducted in controlled settings with participants recruited from urban areas. To date, few research studies have reported the effects of fully remote, telephone-based lifestyle weight management counseling interventions in rural-dwelling adults with overweight and obesity. Of the relevant extant trials, individual and group telephone counseling have been compared [Given the disparities in overweight and obesity, significant barriers to accessing weight management programs, and dearth of scientific study in rural populations, it is important to examine alternative approaches to delivering and evaluating lifestyle weight management interventions. Telephone-based counseling is one method that may increase reach and scalability to better serve rural populations. Therefore, we conducted the Home-based Exercise in Rural Ohio (HERO) study. HERO was a randomized feasibility trial of a 15-week individual telephone-based behavioral counseling intervention versus an active control condition among overweight or obese adults living in rural Ohio counties. We used a point-of-care assessment approach to collect data on all study outcomes. In this paper, we report on the observed changes in body weight, body composition, blood lipids, and inflammatory markers. We hypothesized that the 15-week intervention would yield improvements in these outcomes. Results from this study will be used to subsequently optimize the intervention approach for development of a future large-scale comparative efficacy study.