DVD Lifestyle Intervention (D-ELITE)

DVD 生活方式干预 (D-ELITE)

• 批准号: 9568346
• 负责人: Katherine Hoerster
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9568346
• 关键词: Address; Adoption; Adverse effects; Advisory Committees; Ambulatory Care Facilities; Behavioral; Blood Pressure; Body Weight; Body Weight decreased; Cardiovascular Diseases; Caring; Chronic; Clinical; Communities; Counseling; Decision Making; Development; Diabetes Mellitus; Diet; Dietary intake; Disease; Educational Curriculum; Effectiveness; Enrollment; Equilibrium; Evaluation; Evidence based intervention; Evidence based program; Exposure to; Face; Frequencies; Geography; Goals; Guidelines; Health; Health Personnel; Health Promotion; Health Services Accessibility; Healthcare Systems; Hypertension; Improve Access; Internet; Intervention; Life Style; Life Style Modification; Measures; Medical; Medical center; Modality; Monitor; Obesity; Outcome; Participant; Patient Self-Report; Patients; Persons; Physical Function; Physical activity; Population; Pragmatic clinical trial; Prevalence; Preventive service; Primary Health Care; Program Effectiveness; Provider; Public Health; Randomized; Resources; Risk; Selection Bias; Self Efficacy; Self-Direction; Service delivery model; Services; Stroke; System; Technology; Testing; Time; Tobacco smoking behavior; United States; Variant; Veterans; Visit; Weight; Weight Gain; Weight maintenance regimen; Work; barrier to care; base; behavior change; budget impact; cardiometabolic risk; cardiovascular disorder prevention; care delivery; cost; cost efficient; data warehouse; design; diabetes prevention program; disorder prevention; effective therapy; experience; follow-up; health management; health related quality of life; high risk; improved; intervention participants; lifestyle intervention; mobile computing; obesity treatment; patient oriented; population based; population health; primary care setting; primary outcome; programs; response; secondary outcome; sedentary lifestyle; skills training; sleep quality; success; treatment as usual; web site; weight loss intervention

More than a third of US Veterans who receive care through the VHA are obese, putting them at higher risk for multiple serious chronic health conditions including diabetes, cardiovascular disease, hypertension, and stroke. Losing even small amounts of weight can reduce the risks associated with those conditions. Lifestyle modification is the cornerstone of weight loss treatment. While efficacious lifestyle interventions for obesity exist, finding evidence-based programs that are scalable, cost-efficient, and serves a diverse VA population is a priority for the National Center for Health Promotion and Disease Prevention (NCP). In response, VA disseminated MOVE! Weight Management Program for Veterans (MOVE!) in 2006, a comprehensive, evidenced-based intervention that combines diet and physical activity counseling with behavior change strategies. MOVE! results in meaningful weight loss for those who actively engage in the program, but less than 5% of Veterans eligible for the program participate, and among those, few participate at a level that would result in meaningful weight loss. To address the growing burden that obesity places on Veterans and the health care system, VA now faces the challenge to improve access to comprehensive lifestyle interventions using a patient-centered and population-based approach. We aim to fill this gap by producing evidence on the effectiveness of a proven 12-month pragmatic DVD-based self-directed lifestyle intervention targeting modest, clinically meaningful weight loss and increased physical activity among obese Veterans. The curriculum, aimed at gradual weight loss through progressive healthful changes in diet quality and physical activity and behavioral skills training, is grounded in the Diabetes Prevention Program's (DPP) Group Lifestyle Balance (GLB) 12-session DVD. The program encourages supplementary goal setting and self-monitoring via the Heart360 website, and optional remote lifestyle coaching. We propose to leverage the VA's Corporate Data Warehouse to identify and enroll 500 obese Veterans. We will randomize participants to receive usual care or the lifestyle intervention. As primary outcomes, we will test whether, compared with usual care controls, intervention participants have better outcomes through 12 months of follow-up on weight loss and self-reported physical function. Secondary outcomes through 24 months include sustained weight loss, physical function, physical activity, sedentary behavior, diet quality, blood pressure, sleep quality, self-efficacy, and program reach. Dissemination work with NCP includes development of toolkits and budget impact analyses. We hypothesize that intervention participants will have more weight loss and improved physical function, as well as improvements in physical activity, sedentary behavior, diet quality, blood pressure, sleep quality, and self- efficacy.

通过 VHA 接受护理的美国退伍军人中有超过三分之一患有肥胖症，这使他们面临更高的风险 多种严重的慢性健康问题，包括糖尿病、心血管疾病、高血压和 中风。即使减轻少量体重也可以降低与这些疾病相关的风险。生活方式 改变是减肥治疗的基石。虽然生活方式干预对肥胖有效 存在，寻找可扩展、具有成本效益且服务于多样化退伍军人事务部人群的基于证据的计划是 国家健康促进和疾病预防中心 (NCP) 的优先事项。作为回应，弗吉尼亚州 传播移动！ 2006 年退伍军人体重管理计划 (MOVE!) 将饮食和身体活动咨询与行为改变相结合的循证干预措施 策略。移动！对于那些积极参与该计划的人来说，结果是有意义的减肥，但效果较差 超过 5% 有资格参加该计划的退伍军人参与其中，其中很少有人的参与程度足以 从而达到有意义的减肥效果。为了解决肥胖给退伍军人和其他人带来的日益沉重的负担 医疗保健系统，退伍军人事务部现在面临着改善全面生活方式干预措施的挑战 采用以患者为中心和以人群为基础的方法。我们的目标是通过提供证据来填补这一空白 经过验证的为期 12 个月的基于 DVD 的实用自我导向生活方式干预措施的有效性 肥胖退伍军人中具有临床意义的体重减轻和体力活动增加。课程设置， 旨在通过饮食质量和身体活动的逐步健康改变来逐步减轻体重， 行为技能培训，以糖尿病预防计划 (DPP) 的团体生活方式平衡为基础 (GLB) 12 节 DVD。该计划鼓励通过以下方式进行补充目标设定和自我监控 Heart360 网站，以及可选的远程生活方式指导。我们建议利用 VA 的企业数据 仓库识别并登记 500 名肥胖退伍军人。我们将随机分配参与者接受常规护理或 生活方式干预。作为主要结果，我们将测试与常规护理对照相比，是否 干预参与者通过 12 个月的减肥跟踪和自我报告获得了更好的结果 身体机能。 24 个月的次要结果包括持续体重减轻、身体功能、 身体活动、久坐行为、饮食质量、血压、睡眠质量、自我效能和计划范围。 与 NCP 的传播工作包括开发工具包和预算影响分析。我们假设 干预参与者将有更多的体重减轻和改善的身体功能，以及 身体活动、久坐行为、饮食质量、血压、睡眠质量和自我保健的改善 功效。