USE NOTES:

1.      SIMPLE program requires the facilitator be familiar with group therapy or lifestyle interventions.

2.      Group process is important since our program is partly based on social cognitive theory. We do not know if the intervention will be effective as an individual treatment.

3.      Our study showed other gains in psychosocial outcomes. It may be possible to bill the sessions as group therapy/ rehabilitation session. We suggest you consult with your billing specialist.

4.      We do recommend an initial individual visit with a dietitian to identify eating patterns and a recommendation of 500cal/day food intake reduction. In settings where this is not feasible, there are cheap software programs that assist with 24 hour food recall to identify some easy targets for this calorie reduction. For most of our subjects this was sugar sweetened sodas, candies, or snacks.

5.      Groups in the study were 8-10 patients which we found to be optimum. Sessions lasted an hour per week.

6.      One week is dedicated to on-site supermarket shopping training. We did find this to be both important for outcomes and enjoyable for subjects. In fact, our groups often joined by shoppers in the supermarket.

7.      In the study we did not pay the subjects for their time. We have reimbursed them for healthy food purchases from a list that was provided. This probably is not feasible in many clinical settings and another study we completed showed it to be beneficial but not necessary. Reviewing supermarket itemized receipts for every subject weekly maybe another strategy to verbally reward patients and educate about high calorie purchases in the receipts.

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