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Summary   Objective  New communication technologies have shown some promise in lifestyle weight loss interventions but may be most effective when leveraging face‐to‐face communications. The study reported here sought to test whether weight loss programme attendance and outcomes are greater when offered in‐person at community sites or remotely via videoconference vs. in Federally Qualified Health Centers (FQHCs). In a three‐arm randomized trial among 150 FQHC adults, intervention delivery in community‐sites or via videoconference was tested against a clinic‐based lifestyle intervention (enhanced usual care [EUC]).    Methods  Twice weekly, a nutrition topic was reviewed, and exercise sessions were held in a 20‐week programme delivered either in community settings or via videoconference. The primary outcome was the proportion of participants losing more than 2 kg at 6 (end of treatment) and 12 months in intent‐to‐treat analyses.    Results  Mean (SD) age was 53 years, 82% were women, 65% were African–American, 50% reported $18,000 or less household income and 49% tested low in health literacy, and mean (SD) body mass index was 39 kg m −2 . The proportion losing more than 2 kg of weight in the community site, videoconference and EUC groups was 33%, 34% and 24%, respectively, at 6 months and 29%, 34% and 29% at 12 months. No differences reached significance. Attendance was poor in all groups; 45% of community site, 58% of videoconference and 16% of EUC participants attended at least one session.    Conclusion  Videoconference and community‐based delivery were as effective as an FQHC‐based weight loss programme.

Outcomes of an RCT of videoconference vs. in‐person or in‐clinic nutrition and exercise in midlife adults with obesity