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Research ArticleOriginal Research

Outcomes of Biomarker Feedback on Physical Activity, Eating Habits, and Emotional Health: From the Americans in Motion-Healthy Intervention (AIM-HI) Study

Nia S. Mitchell, Brian K. Manning, Elizabeth W. Staton, Caroline D. Emsermann, L. Miriam Dickinson and Wilson D. Pace
The Journal of the American Board of Family Medicine January 2014, 27 (1) 61-69; DOI: https://doi.org/10.3122/jabfm.2014.01.120347
Nia S. Mitchell
From the Department of Medicine, Division of General Internal Medicine, Colorado Health Outcome Program, and Anschutz Health and Wellness Center (NSM), and the Department of Family Medicine (EWS, CDE, LMD, WDP), University of Colorado Anschutz Medical Campus, Aurora; and the American Academy of Family Physicians National Research Network, Leawood, KS (BKM, EWS, LMD, WDP).
MD, MPH
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Brian K. Manning
From the Department of Medicine, Division of General Internal Medicine, Colorado Health Outcome Program, and Anschutz Health and Wellness Center (NSM), and the Department of Family Medicine (EWS, CDE, LMD, WDP), University of Colorado Anschutz Medical Campus, Aurora; and the American Academy of Family Physicians National Research Network, Leawood, KS (BKM, EWS, LMD, WDP).
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Elizabeth W. Staton
From the Department of Medicine, Division of General Internal Medicine, Colorado Health Outcome Program, and Anschutz Health and Wellness Center (NSM), and the Department of Family Medicine (EWS, CDE, LMD, WDP), University of Colorado Anschutz Medical Campus, Aurora; and the American Academy of Family Physicians National Research Network, Leawood, KS (BKM, EWS, LMD, WDP).
MSTC
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Caroline D. Emsermann
From the Department of Medicine, Division of General Internal Medicine, Colorado Health Outcome Program, and Anschutz Health and Wellness Center (NSM), and the Department of Family Medicine (EWS, CDE, LMD, WDP), University of Colorado Anschutz Medical Campus, Aurora; and the American Academy of Family Physicians National Research Network, Leawood, KS (BKM, EWS, LMD, WDP).
MS
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L. Miriam Dickinson
From the Department of Medicine, Division of General Internal Medicine, Colorado Health Outcome Program, and Anschutz Health and Wellness Center (NSM), and the Department of Family Medicine (EWS, CDE, LMD, WDP), University of Colorado Anschutz Medical Campus, Aurora; and the American Academy of Family Physicians National Research Network, Leawood, KS (BKM, EWS, LMD, WDP).
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Wilson D. Pace
From the Department of Medicine, Division of General Internal Medicine, Colorado Health Outcome Program, and Anschutz Health and Wellness Center (NSM), and the Department of Family Medicine (EWS, CDE, LMD, WDP), University of Colorado Anschutz Medical Campus, Aurora; and the American Academy of Family Physicians National Research Network, Leawood, KS (BKM, EWS, LMD, WDP).
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Article Figures & Data

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    Figure 1.

    Assignment of patients to treatment groups for the Americans in Motion Healthy Intervention (AIM-HI) clinical trial.

Tables

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    Table 1. Demographics: Limited versus Enhanced Feedback Patient Group—Baseline Survey
    VariablesLimited Feedback (n = 304)Enhanced Feedback (n = 306)P value
    Sex
        Female227 (74.7)239 (78.1).3181
        Male77 (25.3)67 (21.9)
    Racial background
        White174 (57.2)177 (57.8).7117
        African American50 (16.4)53 (17.3)
        Other58 (19.1)49 (16.0)
        Missing22 (7.2)27 (8.8)
    Ethnicity
        Non-Hispanic/Latino249 (81.9)263 (85.9).1743
        Hispanic/Latino55 (18.1)43 (14.1)
    Education
        Less than high school13 (4.3)14 (4.6).7647
        High school grad/GED82 (27.0)77 (25.2)
        Some college/graduate school187 (61.5)186 (60.8)
        Missing22 (7.2)29 (9.5)
    Income ($)
        <20,00066 (21.7)59 (19.3).5084
        20,001–50,000104 (34.2)98 (32.0)
        51,001–75,00041 (13.5)46 (15.0)
        >75,00064 (21.1)61 (19.9)
        Missing29 (9.5)42 (13.7)
    Marital status
        Single53 (17.4)64 (20.9).6562
        Married180 (59.2)168 (54.9)
        Separated/divorced/widowed55 (18.1)59 (19.3)
        Missing16 (5.3)15 (4.9)
    • Data are n (%).

    • View popup
    Table 2. Baseline Survey Data (Continuous Descriptors) for Outcome Variables for Limited and Enhanced Feedback Groups*
    VariablesLimited Feedback (n = 304)Enhanced Feedback (n = 306)P value
    MeanSDMeanSD
    Imputed age44.7312.6943.0211.92.0874
    Systolic blood pressure127.316.26125.915.46.2882
    PrimeScreen–AimHi−0.0490.384−0.0650.385.6017
    Overall health variable: self-report0.0170.674−0.0120.700.6356
    MedianIQRMedianIQR
    BMI35.5533.0–41.035.0032.0–40.0.1968
    Fitness4.0002.0–6.04.0002.0–6.0.3369
    SF-12 mental score−0.030−0.9–0.5−0.268−1.1–0.5.2089
    • ↵* Means and standard deviations (SDs) reported for data with normal distribution. Medians (25th to 75th percentiles) reported for data with nonnormal distribution.

    • BMI, body mass index; IQR, interquartile range; SF-12, 12-item Short Form.

    • View popup
    Table 3. One Degree of Freedom Contrast Estimates of the Repeated Mixed Effects Multivariate Regression Model
    OutcomeLimited Feedback Patient Group
    Baseline (n = 304)4 Months (n = 214)10 Months (n = 185)
    EstimateSEEstimateSEChange from Base PEstimateSEChange from Base P
    BMI*37.70.7237.40.72.01437.60.72.242
    Systolic blood pressure†128.81.75128.91.81.985129.61.84.450
    Fitness*3.90.274.20.28.0104.20.28.048
    PrimeScreen*0.00.040.10.04.0000.10.04.000
    SF-12 mental score*0.00.120.20.12.0010.10.12.304
    HealthState*65.72.5465.32.67.82769.52.73.041
    Enhanced Feedback Patient Group
    Baseline (n = 306)4 Months (n = 184)10 Months (n = 192)
    EstimateSEEstimateSEChange from Base PEstimateSEChange from Base P
    BMI*36.90.7236.70.720.11536.60.720.054
    Systolic blood pressure†128.01.77128.51.850.621125.51.850.011
    Fitness*3.90.284.00.280.2453.90.280.771
    PrimeScreen*0.00.040.10.040.0000.20.040.000
    SF-12 mental score*−0.20.120.00.120.0270.00.120.031
    HealthState*66.72.5667.92.740.49770.72.740.023
    • The models were adjusted for repeated measures, clustering of patients within practices, age, comorbidities, education, sex, income, marital status, race, and ethnicity.

    • ↵* Multivariate model: P < .05, time.

    • ↵† Multivariate model: P < .05, time by patient group interaction.

    • BMI, body mass index; SE, standard error; SF-12, 12-item Short Form.

    • View popup
    Table 4. One Degree of Freedom Contrast Estimates of the Repeated Mixed Effects Multivariate Regression Model: Mean Difference in Change from Baseline by Patient Intervention Group
    OutcomeChange Between Groups at 4 Months†Change Between Groups at 10 Months†P Value
    Mean95% Confidence IntervalMean95% Confidence Interval
    BMI0.095−0.220 to 0.410−0.085−0.406 to 0.237.583
    Systolic blood pressure*0.478−2.224 to 3.180−3.262−6.011 to −0.513.025
    Fitness−0.168−0.493 to 0.158−0.207−0.532 to 0.118.392
    PrimeScreen0.013−0.050 to 0.0760.055−0.009 to 0.119.232
    SF-12 mental score−0.077−0.270 to 0.1160.078−0.120 to 0.276.356
    HealthState1.602−3.248 to 6.4520.304−4.627 to 5.235.802
    • The models were adjusted for repeated measures, clustering of patients within practices, age, comorbidities, education, sex, income, marital status, race, and ethnicity.

    • ↵* Multivariate model: P < .05, time by patient group interaction.

    • ↵† Coefficients are in terms of differential change from baseline by the enhanced feedback group compared to the limited feedback group.

    • BMI, body mass index; SF-12, 12-item Short Form.

    • View popup
    Table 5. Weight Change as a Percentage of Initial Weight
    Limited (n = 183)Enhanced (n = 191)P value
    Weight loss.2
        0–<52534
        ≥51518
    Weight gain
        0–<54637
        ≥51312
    • Data are percentages. Columns do not total 100% because of rounding.

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The Journal of the American Board of Family     Medicine: 27 (1)
The Journal of the American Board of Family Medicine
Vol. 27, Issue 1
January-February 2014
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Outcomes of Biomarker Feedback on Physical Activity, Eating Habits, and Emotional Health: From the Americans in Motion-Healthy Intervention (AIM-HI) Study
Nia S. Mitchell, Brian K. Manning, Elizabeth W. Staton, Caroline D. Emsermann, L. Miriam Dickinson, Wilson D. Pace
The Journal of the American Board of Family Medicine Jan 2014, 27 (1) 61-69; DOI: 10.3122/jabfm.2014.01.120347

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Outcomes of Biomarker Feedback on Physical Activity, Eating Habits, and Emotional Health: From the Americans in Motion-Healthy Intervention (AIM-HI) Study
Nia S. Mitchell, Brian K. Manning, Elizabeth W. Staton, Caroline D. Emsermann, L. Miriam Dickinson, Wilson D. Pace
The Journal of the American Board of Family Medicine Jan 2014, 27 (1) 61-69; DOI: 10.3122/jabfm.2014.01.120347
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