Tailored, Interactive Text Messages for Enhancing Weight Loss among African American Adults: The TRIMM Randomized Controlled Trial

Michael Lin, Zayan Mahmooth, Nicket Dedhia, Robin Frutchey, Catherine E. Mercado, David H. Epstein, Kenzie L. Preston, Michael C. Gibbons, Janice V. Bowie, Alain B. Labrique, Lawrence J. Cheskin

Research output: Contribution to journalArticlepeer-review


Background Helping patients control obesity remains a clinical challenge for internists, and African Americans experience obesity rates higher than other racial/ethnic groups. Purpose To investigate whether a behavioral theory-based mobile health intervention would enhance weight loss when added to standard care among overweight/obese African American adults. Methods A randomized controlled trial of 124 adults recruited from Baltimore-area African American churches. Participant follow-up ended March 2013. Participants were randomized to standard care (included one-on-one counseling sessions with a dietitian and a physician) or standard care plus daily tailored text messages for 6 months. Text messages were delivered in phases: preparation, reinforcement of participant-selected diet and exercise goals, reflection, goal integration, weight loss methods, and maintenance. There were follow-up visits at 3, 6, and 12 months. Primary outcome was weight change from baseline to end-intervention at 6 months. Secondary outcomes included weight change at 3 months, engagement, and satisfaction with the intervention. Results Sixty-three participants were randomized to the mobile health intervention and 61 to standard-care control. Weights were collected in-window for 45 (36.3%) at 3 months and 51 (41.1%) at 6 months. Mean weight loss at 3 months was 2.5 kg greater in the intervention group compared with standard care (95% confidence interval [CI], -4.3 to -0.6; P <.001), and 3.4 kg greater (95% CI, -5.2 to -1.7; P =.001) at 6 months. Degree of engagement with messages was correlated with weight loss. Conclusions While attrition was high, this study supports a tailored, interactive text-message intervention to enhance weight loss among obese African-American adults.

Original languageEnglish (US)
Pages (from-to)896-904
Number of pages9
JournalAmerican Journal of Medicine
Issue number8
StatePublished - Aug 1 2015


  • African-American
  • Obesity
  • Text messaging
  • Weight loss

ASJC Scopus subject areas

  • Medicine(all)


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