Feasibility and efficacy of a novel technology-based approach to harness social networks for weight loss: the NETworks pilot randomized controlled trial.

OBJECTIVE: Harnessing social support from existing social ties represents a key weight control practice. This trial evaluated an intervention that provided health-promoting technologies for leveraging the influence of existing social ties. METHODS: Volunteers (N = 36) with a body mass index between 25 and 55 kg m-2 were randomized to a 16-week, in-person, technology-supported behavioural weight-loss treatment (standard behavioural treatment) or the same programme supplemented by providing self-selected members of participants' social networks with a digital body-weight scale and Fitbit Zip physical activity tracker (ENHANCED). RESULTS: Average weight losses from baseline to 16 weeks did not significantly differ between groups (standard behavioural treatment, 5.30%, SD =3.93%; ENHANCED, 5.96%, SD = 5.19%, p = 0.63). By the 1-year follow-up, standard behavioural treatment had lost 5.63%, SD = 8.14% of baseline weight versus 4.73%, SD = 9.43% for ENHANCED (p = 0.82). ENHANCED reported self-weighing on more days than did standard behavioural treatment (p = 0.03). Most participants reported high programme satisfaction. Similar improvements were observed in perceived social support for diet and exercise from baseline to 16 weeks in both groups (ps < 0.05) but regressed by 1 year (ps < 0.01). CONCLUSION: Although feasible to implement, this technology-based, social support approach failed to enhance outcomes of a face-to-face, group-based behavioural weight-loss treatment.

Costs associated with tuberculosis control programs at hospitals caring for children.

OBJECTIVE: No data are available on the costs of implementing infection control measures for the control of Mycobacterium tuberculosis (MTB) in pediatric settings. In this study we determined the cost of MTB control measures at three hospitals caring for children. DESIGN: Infection control and tuberculosis (TB) coordinators obtained cost data retrospectively for the years 1994 to 1995 for tuberculin skin test programs, respiratory protection programs and the retrofit or new construction of environmental controls in pediatric settings. SETTING: Two pediatric hospitals and one pediatric ward in a large tertiary care hospital. RESULTS: Total expenditures for TB controls ranged from $15270 to $28158 for the 2-year study period. Engineering controls involved the largest capital outlay at two of three facilities. Average yearly tuberculin skin test costs ranged from $949 to $12504/hospital. Respiratory protection programs cost from $480 to $1680 during the 2-year study period. CONCLUSIONS: Costs associated with implementing control measures varied slightly by hospital but were less than those incurred by hospitals caring for adults. These costs represent improvements made to upgrade selected aspects of hospital TB control programs, not the cost of an optimal TB control program. Optimal TB control programs in pediatric settings have yet to be described.