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Daily Archives: November 6, 2015

Using A Weight-Loss App? Study Says It Doesn’t Help Much

Young American adults own smartphones at a higher rate than any other age group. Researchers from Duke University wanted to see if capitalizing on that smartphone usage with a low-cost weight-loss app might help the 35 percent of young adults in the U.S. who are overweight or obese.

If you’re rooting for smartphones to solve all our health problems, you’re not going to like what the researchers found. The smartphone app didn’t help young adults lose any more weight than if they hadn’t been using the app at all.

fat phone 570The study, which was published in the journal Obesity, looked at 365 young adults ages 18 to 35. A third of the participants used an Android app specifically created for the study, which not only tracked their calories, weight and exercise but also offered interactive features like goal setting, games and social support. Another third of the participants received six weekly personal coaching sessions, followed by monthly phone follow-ups. Plus, this personal coaching group was also encouraged to track their weight, calories and exercise via smartphone. The last third of the participants were given three handouts on healthy eating and exercise – nothing else.

Researchers tracked the young adults’ progress after six months, one year and two years. The personal coaching group had lost more weight than the other two groups after six months, but that lead vanished at the one- and two-year follow-ups. As for the group using the smartphone app, their average weight loss was never more than the other two groups.

Lead author Dr. Laura Svetkey said that she and her colleagues were both surprised and disappointed at the results. “Given the seeming power of cell phone apps and frankly the popularity of these health and fitness apps in the commercial world, we thought this might be a really good strategy to provide effective intervention very broadly and potentially at low cost,” said Svetkey, a professor of medicine at Duke University School of Medicine.

This KHN story also ran on NPR. It can be republished for free (details). logo npr

But, Svetkey says it’s difficult to get the same level of intensity in an app that you might get through personal coaching, and people have the tendency to stop using weight-loss apps after a while. “We know that in general, the more engaged people are in intervention, the more they’re going to succeed from it,” Svetkey said. “And so perhaps we need to rethink how to make a weight-loss intervention on your cell phone more engaging.”

The stakes in helping young adults lose weight are high. Weight gain during the young adult years is associated with a variety of health issues later in life, including metabolic syndrome and cardiovascular disease, Svetkey said.

It’s not clear if these results would apply to apps that are commercially available. Svetkey says she is only familiar with one clinical study that looked at a popular commercial weight-loss app, which was also found to be ineffective at promoting weight loss. Yet that’s not to say these apps won’t work for certain people in certain circumstances, she says.

Weight Watchers, which uses a combination of apps and coaching in a group setting, and MyFitnessPal, a very popular food and exercise tracking app, didn’t respond to requests for comment by publication time.

These study results aren’t reason to give up hope about the potential for weight-loss apps, Svetkey adds, but are instead reason to intensify research efforts in this area. More work is needed to understand how to harness these technologies and leverage their strengths in a way that will lead people to change their eating and exercise behaviors, she says.

But is there any real harm in using one of these apps, even if they aren’t proven effective in research studies? Svetkey suggests that it could be a matter of wasted effort.

“We have a very serious epidemic,” Svetkey said, “and if we’re spinning our wheels on things that don’t work then that’s energy not being put towards finding and disseminating things that do work.”

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Calif. Medicaid Patients With Cancer Fare Worse Than Those With Other Coverage

Cancer patients insured by California’s health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by University of California-Davis researchers.

While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC-Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.

Understanding how well Medicaid (called Medi-Cal in California) serves cancer patients is crucial, experts say, because as much as 10 percent of California’s Medicaid expenditures go to cancer care. And Medi-Cal has grown to cover more than 12 million Californians – nearly a third of the state’s population.

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This KHN story can be republished for free (details).

“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of the UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”

The UC Davis researchers used California Cancer Registry data to study the experiences of approximately 700,000 Californians diagnosed with breast, colon, rectal, lung, and prostate cancer between 2004 and 2012. They tracked how early these patients were diagnosed, their quality of treatment and their five-year relative survival rates according to their type of insurance. The types were Medi-Cal, Medicare, dual Medi-Cal/Medicare (for lowest-income seniors), private insurance, Department of Defense (DOD) insurance and Department of Veterans Affairs (VA) insurance.

Among the findings:

* Medi-Cal patients were diagnosed with advanced (stage IV) prostate cancer more than three times as often as patients with private insurance or DOD coverage.

* Medi-Cal patients with breast, colon or rectal cancer were more likely to be diagnosed at an advanced stage and to have worse five-year survival rates than people with other types of insurance.

  • Low-income seniors covered by Medicare and Medi-Cal, known as “dual-eligible patients,” were the least likely to receive recommended treatment for breast and colon cancer.
  • VA patients waited the longest to be treated for breast, colon, rectal, lung and prostate cancers, but their outcomes compared favorably to patients with other types of health insurance and they were generally more likely to receive recommended treatment.

What researchers still don’t know, Kizer said, is the reason for these disparities. It’s possible that Medi-Cal patients drop on and off the rolls, missing preventive screenings that could help detect cancers earlier. Audits and studies also have shown that some of the state’s Medi-Cal patients have difficulty getting access to doctors and specialists.

Researchers also can’t explain why Medi-Cal patients are less likely than patients with other kinds of insurance to receive recommended treatment after they are diagnosed. And they also don’t know whether cancer patients fare better or worse in Medi-Cal managed care programs, which now cover most of California’s Medicaid population.

“It’s not acceptable to have these variations” based on insurance coverage, particularly regarding breast and colon cancers for which preventive screenings are well-established and effective, said Christina Clarke, a research scientist at the Cancer Prevention Institute of California and a consulting associate professor at the Stanford University School of Medicine. She was not involved in the study.

“What’s particularly poignant is that we’re seeing these big disparate outcomes among groups in cancers where we have strong playbooks. That’s the tragic thing here,” Clarke said. “There’s a body count and we’d like to figure out a better way to insure that all Californians are getting the recommended screening for these deadly cancers and treatment according to guidelines. We have a lot of work to do.”

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Viewpoints: Keep Health Costs Down; Political Riders May Heat Up Budget Battle

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Research Roundup: Medicaid’s Obesity Costs; Where Kids Get Mental Health Care

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State Highlights: Calif. Hospitals Could Cut Inpatient Costs 25%, Analysis Finds; CDC Investigating E. Coli Outbreak In Ore. And Wash.

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Puerto Rico Financial Woes Trigger Rally To Urge Washington To Improve Health Care Funds For U.S. Territory

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Kansas Medicaid Costs Likely To Exceed 2016 Estimates

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Budget Deal Will Impact Medicare Hospital Reimbursement Rates

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Sanders Seeks To Regain Campain-Trail Momentum With Policy Speech

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House Panel Advances Mental Health Bill, But Dems Complain Their Concerns Weren’t Met

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