Balance (Equilibrio in Spanish) tests a pragmatic intervention for weight gain prevention (defined as <= 3% weight gain at 24-months) within primary care among safety net clinics throughout central North Carolina.

Balance randomized adults with obesity who were patients at local Piedmont Health Services (PHS) federally-qualified community health centers. Participants were randomized to one of two arms: 1) a weight gain prevention intervention with tailored behavior change goals and tracking, daily weighing on a network-connected electronic scale, and responsive weight and goal coaching delivered remotely by health center registered dietitians; or 2) a usual care program with automated healthy living text messages and print materials and routine primary care.

Trial recruitment ended in December 2018, with 443 total patients randomized from five participating community health centers. Aligning with its pragmatic design, outcome data are extracted from the PHS electronic medical records at 24-months post-randomization. The final trial participant will reach the 24-month timepoint in December 2020. We look forward to sharing the outcome results beginning in 2021.