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Evidence for Community-Based Approaches to Weight Loss: A Case for Revising the Centers for Medicaid and Medicare Services Reimbursement Structures

      To the Editor: In a recent issue, Katula and colleagues
      • Katula J.A.
      • Vitolis M.Z.
      • Morgan T.M.
      • et al.
      The Healthy Living Partnerships to Prevent Diabetes Study: 2-year outcomes of a randomized controlled trial.
      report an RCT that demonstrated the effectiveness of a community-based lifestyle intervention on weight, waist circumference, insulin resistance, and blood glucose up to 2 years. In addition to achieving long-term effects that were on par with the Diabetes Prevention Program lifestyle intervention,
      • Whittemore R.
      A systematic review of the translational research on the Diabetes Prevention Program.
      the intervention was elegantly designed to be implemented in a manner to facilitate sustainability in a real-world community setting. The intervention was conducted in community parks and recreation centers where kitchens and communal space were utilized for cooking demonstrations, exercise classes, and group meetings. Lifestyle interventions can be resource-intensive, but community settings often have the space and resources for this type of programming. To offset costs, interventionists were community health workers trained by registered dietitians. The intervention was also of sufficient intensity and dose to allow participants ample time to learn and practice the behavioral strategies that studies have demonstrated to be key to weight loss. Their findings add to the growing body of research supporting the effectiveness of lifestyle interventions when implemented at sufficient intensity by highly trained staff in settings accessible to the intended participants.
      • Whittemore R.
      A systematic review of the translational research on the Diabetes Prevention Program.
      Community approaches are particularly crucial to reducing health disparities in diverse populations.
      • Lurie N.
      • Dubowitz T.
      Health disparities and access to health.
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      References

        • Katula J.A.
        • Vitolis M.Z.
        • Morgan T.M.
        • et al.
        The Healthy Living Partnerships to Prevent Diabetes Study: 2-year outcomes of a randomized controlled trial.
        Am J Prev Med. 2013; 44: S324-S332
        • Whittemore R.
        A systematic review of the translational research on the Diabetes Prevention Program.
        Translational Behavioral Medicine. 2011; 1: 480-491
        • Lurie N.
        • Dubowitz T.
        Health disparities and access to health.
        JAMA. 2007; 297: 1118-1121
      1. Decision memo for intensive behavioral therapy for obesity, 2011. www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?&NcaName=Intensive%20Behavioral%20Therapy%20for%20Obesity&bc=ACAAAAAAIAAA&NCAId=253&.

        • U.S. Preventive Services Task Force
        Screening and interventions for overweight and obesity in adults.
        Agency for Healthcare Research and Quality, Rockville MD2003 (Report No. 00-4084)
        • Daumit G.L.
        • Dickerson F.B.
        • Wang N.
        • et al.
        A behavioral weight loss intervention in persons with serious mental illness.
        N Engl J Med. 2013; (March 21 (epub ahead of print))