Table 2.

Description of Intervention Components and Providers.

Study	Intervention Group	Intervention Frequency and Provider	Method of Intervention Delivery	Role of Primary Care Provider (PCP)	Components of Diet, Physical Activity (PA), and Behavior Therapy (BT)
TRADITIONAL BEHAVIORAL COUNSELING
Primary Care Practitioners/Trained Interventionists
Kumanyika et al,16 2012	1. Basic	Counseling every 4 mo with the PCP based on Diabetes Prevention Program (DPP) materials. PCPs completed 3 hr training.	On-site visits with PCP.	Provided brief counseling during visits every 4 mo.	Diet: 1200–1499 kcal/day with 30 g fat (if weight <100 kg) or 1500–1800 kcal/day with 40 g fat (≥100 kg); provided calorie counter. PA: 150 min of moderate PA/week, typically walking. BT: Prescribed DPP behavior change program, including self-monitoring of diet and PA; goal setting.
	2. Basic Plus	Visits every 4 mo with PCP; 10–15 min monthly individual sessions with a lifestyle coach, usually a medical assistant (MA). MAs completed 3 hr training.	On-site visits with PCP and lifestyle coach.	Same as for Basic.	Diet: Same as for Basic. PA: Same as for Basic. BT: Same as for Basic.
Tsai et al,17 2010	1. Control	Quarterly usual care meetings with PCP (weight management, ~2–3 min). PCPs trained in use of weight loss handouts.	On-site visits with physician.	Regular medical care with weight management as part of visit. PCPs reviewed weight loss handouts at quarterly visits.	Diet: Standard advice to eat healthy diet; provided calorie counter and meal plans. PA: Standard advice to exercise more; provided pedometer. BT: 1–2 page handouts from NIH/Weight-Control Information Network, including healthy behaviors.
	2. Brief Counseling	Quarterly usual care meetings with PCP (weight management, ~2–3 min); 8 brief (10–15 min) individual meetings with MAs at weeks 0, 2, 4, 8, 12, 16, 20, 24. MAs completed 3 hr training.	On-site visits with PCP or MA (with occasional phone counseling by MAs for missed visits).	Same as for Control group.	Received same materials as control group. Diet: 1200–1499 kcal/day (<250 lb) or 1500–1800 kcal/day (≥250 lb). PA: gradual increase to 175 min/week, typically walking. BT: Prescribed DPP behavior change program, including self-monitoring of diet and PA; handouts at each visit; weighed at each visit and reviewed food records with MA.
Wadden et al,18 2011	1. Usual Care	Quarterly usual care visits with PCP (weight management, ~5–7 min). PCP completed 6–8 hr training at baseline.	On-site, routine clinical visits with physician.	Discussed handouts; reviewed participants’ weight change;	Diet: 1200–1500 kcal/day (<113.4 kg) or 1500–1800 kcal/day (≥113.4 kg); received calorie counting book and pedometer. PA: Gradual increase to 180 min/week, typically walking. BT: Handouts from NHLBI’s “Aim for a Healthy Weight”.
	2. Brief Lifestyle Counseling	Quarterly usual care visits with PCP (weight management, ~5–7 min); monthly individual meetings (~10–15 min) with a lifestyle coach, usually a MA (with two visits in month 1). MAs completed 8-hr training at baseline and received monthly group supervision thereafter.	On-site, individual visits with PCP and MA. In year 2 counseling visits could be completed every other month by phone.	Same as for Usual Care.	Diet: Same prescription and materials as Usual Care. PA: Same PA prescription as Usual Care. BT: Prescribed DPP behavior change program, including self-monitoring of diet and PA; handouts at each visit; weighed at each visit and reviewed food records with MA.
Trained Interventionists
Appel et al,19 2011	1. Control	One session with weight loss coach (a university employee) at randomization and, if desired, one after final data collection visit.	On-site, individual visit with staff member.	None	Received brochures and a list of recommended websites promoting weight loss.
	2. Remote Support Only	Individual, 20-min phone calls weekly for 12 weeks, then monthly. Coaches were trained employees from a disease management company.	Telephone and web-based counseling.	Reviewed progress reports at routine office visits; encouraged participation and engagement in intervention.	Diet: DASH diet with 1200–2200 kcal/day. PA: Increase to 180 min/week of moderate intensity. BT: Self-monitoring of diet and PA; problem solving and social support; study website; motivational interviewing elements.
	3. In-Person Support	Combination of 9 group (90 min) and 3 individual (20 min) contacts for 12 weeks, then 2–3 such contacts per month. Coaches were trained university employees.	Off-site counseling (at academic medical center); also telephone and web-based support	Same as for Remote support only.	Diet: Same as for Remote Support Only. PA: Same as for Remote Support Only. BT: Same as for Remote Support Only
Ma et al,20 2013; Xiao et al,43 2013	1. Usual Care	None	None	None	No materials provided.
	2. Coach-Led, Intervention	12 in-person, group sessions (90–120 min) in mo 1–3; contact every 2–4 weeks by e-mail or telephone in mo 4–15. Registered dietitian (certified to deliver the DPP) and a fitness instructor jointly taught all classes.	On-site, group classes during mo 1–3; e-mail or telephone contacts thereafter.	None	Diet: Low-fat diet to induce 500–1000 kcal/day energy deficit. PA: ≥150 min of moderate PA/week; 30–45 min of supervised PA at weekly class during mo 1–3. BT: DPP Group Lifestyle Balance program; AHA Heart 360 website for physical activity and goal setting; weight scale and pedometer for self-monitoring and goal setting.
	3. Self-directed DVD intervention	Orientation class in-person plus instruction to watch 12 DPP lifestyle sessions (90–120 min) via DVD at home during mo 1–3; lifestyle coach sent standardized bi-weekly reminder messages during mo 1–15.	On-site orientation session; intervention delivered via home-based DVD; e-mail messages (standardized) during maintenance.	None	Diet, PA, and BT: DPP on DVD; use of AHA Heart 360 website for physical activity and goal setting; given weight scale and pedometer for self-monitoring and goal setting.
ALTERNATIVE BEHAVIORAL COUNSELING
Primary Care Practitioners/Trained Interventionists
Christian et al,21 2011	1. Control	Clinic staff provided education packet prior to baseline visit.	Written materials.	None	Packet of health education materials at baseline visit addressing diabetes, diet, and exercise.
	2. Intervention	Twice-yearly counseling with PCP during routine visits. Clinic staff administered one computer-based assessment session prior to baseline visit and one session at 6 mo. PCP completed 3-hr training in motivational interviewing.	On-site; computer assessment, physician feedback.	Received computer-generated report with summary of each patient’s assessment; patients were provided recommendations for behavior change following stages of change and motivational interviewing.	Diet, PA, and BT: Individualized, computer-generated report addressing participant-identified barriers to making lifestyle changes; motivational interviewing to reduce calorie intake and increase PA; increase self-efficacy to make lifestyle changes; 30-page guide providing general supplemental information on diabetes prevention and achieving dietary and physical activity goals.
Trained Interventionists
Bennett et al,22 2012	1. Control	Initial visit with program staff.	Self-help booklet.	None	NHLBI’s “Aim for a Healthy Weight” booklet provided.
	2. Intervention	12 monthly and 6 bimonthly calls (15–20 min); 12 optional, monthly group sessions; 1 brief standardized message from PCP. Trained community health educators.	Telephone, study website, interactive voice response system	Delivered at least 1 message about importance of intervention; electronic signature included on behavior change prescription.	Diet: Tailored behavior change goals to create an energy deficit. PA: Walk 10,000 steps/day, 20 min/day brisk walking, strength training 2 days/week. BT: Goal prescriptions; self-monitoring; tailored skills training; problem solving; motivational interviewing elements.
de Vos et al,23 2014	1. Control	None	None	None	No materials provided.
	2. Intervention	Referral to registered dietitian for up to 4 hr of counseling in year 1; up to 20, 1-hr group exercise classes with physical therapist in first 6 mo. Dietitians trained in motivational interviewing.	Off-site individualized meetings and physical activity courses.	None	Diet: Tailored advice for a low-fat or low-calorie diet. PA: Increased physical activity; physical activity classes offered. BT: Motivational interviewing; goal setting.
Greaves et al,24 2008	1. Control	Written guidelines at study outset; 2 individual sessions with counselors at study end; clinic staff.	Received standardized information packet promoting diet and physical activity.	None	Diet, PA, and BT: British Heart Foundation health-promotion materials; National Health Service Smoking Cessation Service ‘Green Book;’ locally produced information on ‘walk and talk’ activities.
	2. Intervention	Up to 11 individual visits (~30 min) in-person or by telephone for 6 mo. Health promotion counselors, including one nurse and three postgraduate students, completed 2-day course in motivational interviewing.	On-site, individual consultations and telephone contacts.	None	Diet: Reduce calories, fat, and portion size; increase fiber. PA: Increase overall physical activity within existing lifestyle. BT: Motivational interviewing; relapse prevention; self-monitoring.
Hardcastle et al,2008;25 201344	1. Minimal Intervention	Clinic staff provided written materials.	Written materials	None	Diet: Written materials encouraging increased fruit and vegetable intake and reduced fat. PA: Written materials encouraging 30 min/day of PA. BT: None
	2. Motivational Interviewing	One consultation with PA specialist or registered dietitian with opportunity to meet 4 more times (20–30 min) following 6 mo. PA specialist and registered dietitian participated in two 4 hr training sessions focused on MI.	On-site, individual consultation.	None	Diet: Motivational interviewing to improve diet. PA: Motivational interviewing to increase physical activity. BT: Motivational interviewing integrated with a stage-matched approach; agenda setting; exploration of the pros and cons, importance and confidence rulers, strengthening commitment to change and negotiating a change plan.
Logue et al,262005	1. Augmented Usual Care	Semi-annual meeting with registered dietitian for 10-min sessions based on the USDA Food Guide Pyramid or a Soul Food Guide Pyramid.	On-site, individual meeting.	None	Diet: Recommendations based on dietary recalls and standard dietetic practice (Dietary Guidelines for America). PA: Recommendations based on exercise recalls. BT: Counseling based on either USDA Food Guide Pyramid (Dietary Guidelines for Americans) or a Soul Food Guide Pyramid; Behavioral self-monitoring.
	2. Trans-theoretical Model	Same dietitian visits as Usual Care; monthly 15-min telephone calls with a weight-loss advisor, conducted “stage-of-change” (SOC) assessments for five target behaviors every month; mailed SOC and target behavior-matched workbooks. Weight loss advisor trained in SOC, supervised by psychologist.	On-site, individual meeting, mailings, telephone support.	Discussion with patient during routine visits, facilitated by SOC pocket card; received periodic reports summarizing patient progress with respect to target behaviors.	Diet: Counseling based on standard dietetic practice (Dietary Guidelines for America). PA: Counseling to increase physical activity. BT: SOC assessment every 2 mo for target behaviors; stage- and behavior-matched workbooks; assessment for depression, anxiety, and binge eating disorder every 6 mo.
Ross et al,27 2012	1. Usual Care	Routine visit with physician.	Usual schedule of meetings with physicians.	Provide general advice during routine office visit (typically once a year).	Diet, PA, and BT: Advice regarding benefits of PA for obesity reduction; at end of intervention, patients Invited to attend workshop on strategies to integrate PA and healthy eating into lifestyle.
	2. Behavioral Intervention	Health educators (in kinesiology) provided 15, 1 hr sessions during mo 1–6; monthly, 30–60 min sessions during mo 7–24, based on participants’ progress.	On-site, individual, tailored counseling.	None	Diet: Promote daily consumption of whole-grain foods, fruits, vegetables, legumes, and low-fat dairy products. PA: 45–60 min/day of moderate PA. BT: Motivational interviewing (mo 1–6); individually tailored counseling based on transtheoretical model and social cognitive theory; goal setting.

BT= behavior therapy; MA= medical assistant; PA= physical activity; PCP= primary care provider; SOC= stage of change; NHLBI= National Heart, Lung, and Blood Institute.