[Telemedical Franconian Obesity Aftercare Therapy (Tele-FANT) Results of a Formative Evaluation].

Abstract

Introduction: Following rehabilitation, patients are often unable to continue with the behavioral changes they had learned there in the long term. It is therefore important to offer aftercare services to improve self-management. Internet-based and telephone aftercare concepts in particular are low-cost and flexible in application, and offer an opportunity to significantly increase the use of aftercare measures. In, the"Tele-FANT" project, obese patients were supported by an aftercare therapist over a period of 12 months following their inpatient rehabilitation stay by regular telephone or video consultations.

Method: A one-group pre-post design was used for the formative evaluation. Participants took part in a written survey at the start of rehabilitation, at the end of rehabilitation and 4, 8 and 12 months after rehabilitation. As a key variable, body weight (external measurement by the family doctor) was also recorded at all measurement times to calculate the percentage weight loss from the start of rehabilitation. Descriptive parameters were calculated at the beginning, as well as mean differences and standardized effect sizes (SES) at the post-measurement time points.

Results: A total of 47 obese rehabilitation patients (mean BMI=44.56, SD=7.23) from the Frankenlandklinik Bad Windsheim were recruited to participate in the aftercare program. The complete program up to the 12-month follow-up was completed by 30 participants (drop-out: 36.2%). The remaining participants showed a high level of acceptance for both the structural processes and the content of the aftercare program. A weight loss of at least 10% was achieved by 13 participants (50%) at the 12-month follow-up, a further 4 participants (15.4%) had lost 5 to 10%. The participants were able to reduce their BMI by an average of 4.45 BMI points from 43.69 (SD=7.25) to 39.24 (SD=7.25) since the start of rehabilitation (mean effect size: SES=0.61).

Conclusion: In the formative evaluation, the "Tele-FANT" aftercare program shows good feasibility and promising results with regard to the goal of weight reduction/stabilization. However, the high drop-out rate indicates that some of the participants were not satisfied with the program or were unable to achieve the desired outcome. The next step would be to test the effectiveness of the "Tele-FANT" aftercare concept in a randomized control group study.