Improving weight management at the VA: Enhancing the MOVE!23 for primary care

改善 VA 的体重管理：加强初级保健的 MOVE!23

• 批准号: 8398206
• 负责人: Melanie Jay
• 金额: --
• 依托单位: VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-10-01 至 2017-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8398206
• 关键词: Address; Adherence; Adopted; Area; Award; Behavior; Behavior assessment; Behavioral; Body Weight decreased; Caring; Case Manager; Chronic Disease; Clinic; Clinical; Clinical Trials Design; Comorbidity; Computer Assisted; Computer software; Consultations; Counseling; Data; Development; Diabetes Mellitus; Diet; Evaluation; Expert Systems; Foundations; Goals; Grant; Health; Health Promotion; Healthcare Systems; High Prevalence; Hyperlipidemia; Hypertension; Institution; Instruction; Intention; Intervention; K-Series Research Career Programs; Life Style; Medical Care Team; Mentors; Mentorship; Methodology; Methods; Modeling; Motivation; New York; Nutritional Study; Obesity; Outcome; Overweight; Patients; Phase; Physical activity; Pilot Projects; Play; Population; Preventive Intervention; Primary Health Care; Process; Provider; Public Health; Qualitative Methods; Randomized; Randomized Controlled Trials; Reading; Recruitment Activity; Research; Research Personnel; Research Training; Resources; Risk; Role; Self Efficacy; Services; Shoulder; System; Technology; Telephone; Testing; Time; Training; Translational Research; United States National Institutes of Health; Universities; Veterans; Weight; Weight maintenance regimen; Writing; arm; base; behavior change; brief intervention; computer generated; computerized; cost; design; diet and exercise; digital; dissemination research; effective intervention; health administration; health disparity; implementation science; improved; innovation; member; obesity prevention; obesity treatment; patient population; post intervention; prevent; primary care setting; programs; public health relevance; skills; software development; theories; therapy development; tool; treatment program

DESCRIPTION (provided by applicant): Project Summary In this application for a Mentored Career Development Award (CDA-2), Melanie Jay, MD, MS describes her plan to pursue training and research to achieve her long-term goal of becoming an independent, clinically- oriented, translational investigator dedicated to improving the treatment and prevention of obesity at the Veterans Health Administration (VHA). Her specific and training aims address the hypothesis that a brief, computer-assisted intervention to treat obesity in primary care will be feasible and acceptable to patients and providers and result in improvements in intermediate (i.e. patient self-efficacy, intention, and motivation to change lifestyle behaviors), behavioral (diet and physical activity improvements), and weight-loss outcomes. Under the sponsorship of Scott Sherman, MD, MPH, the training plan capitalizes on the resources of the VA New York Harbor Healthcare System (HCS), New York University, and the NIH-sponsored New York Obesity Nutrition Research Center, combining formal coursework, directed readings, and experiential components. The plan involves mentorship and didactic instruction in key areas including qualitative methodology, behavior change theories, implementation science, clinical trial design and implementation, obesity innovations, digital media design, advanced statistical analysis, grant writing, and research dissemination. Dr. Jay proposes a three-phased project to enhance the VA MOVE!23 software application so that it can be used as part of a goal- setting intervention to treat obesit in primary care. She will then evaluate this intervention so that it can be adopted to serve the broader primary care Veteran population. During the Formative Phase, she will use qualitative methodologies to inform enhancement of the MOVE!23 software and development of the intervention. During the Development Phase, she will enhance the MOVE!23 software application and develop and pilot-test other components of the intervention. She will then apply for a Clinical Translational Science Institution (CTSI) and/or foundation grant to help support the Evaluation Phase of her project. During the Evaluation Phase, she will conduct a pilot study at the VA New York Harbor HCS primary care clinics to test the feasibility, acceptability, and explore preliminary outcomes of this intervention. She will also explore differences in feasibility and outcomes when telephone counseling is added to the intervention. She will recruit 140 subjects. All subjects will receive the enhanced MOVE!23 and Patient Aligned Care Team (PACT) counseling. They will then be randomized into two intervention arms: PACT counseling only or PACT counseling plus additional telephone counseling support. She will explore differences in feasibility, acceptability, and intermediate, behavioral, and weight loss outcomes at 6 and 12 months pre- and post- within each arm and comparing the two intervention arms. This research and training plan will generate pilot data for the development of a Merit Review application to conduct a 3-arm randomized controlled trial of the intervention. PUBLIC HEALTH RELEVANCE: Project Narrative The high prevalence of obesity and its negative impact on Veteran health make treating and preventing obesity a high priority of the Veteran Health Administration since modest weight loss can prevent and ameliorate chronic disease. Unfortunately, innovative VA obesity treatment programs such as MOVE! do not reach the majority of eligible Veterans. Primary care is an important venue to provide obesity-related services and increase access to obesity care, but, few effective interventions exist that can be delivered in this setting. Dr. Jay proposes to use qualitatitve methods to enhance existing MOVE!23 software for use as part of a brief, computer-assisted primary care-based intervention to treat obesity and improve Veteran Health. She will then do a pilot study to evaluate preliminary outcomes.

描述（由申请人提供）： 该申请中的项目摘要旨在获得指导职业发展奖（CDA-2），医学博士Melanie Jay，MS描述了她进行培训和研究的计划，以实现她成为一个独立的，面向临床的，转化的研究人员的长期目标，致力于改善Veterans Health Administration（VHA）的肥胖症治疗和预防。她的具体和培训的目的是解决以下假设：治疗初级保健肥胖症的简短，计算机辅助的干预措施将是患者和提供者可行的，并且可以改善中级（即患者自我效能，意图和动机，以改变生活方式行为），行为和身体活动的改善（饮食和体力活动）以及体重减轻 - 以及体重减轻 - 以及体重减轻 - 以及体重减轻。在医学博士斯科特·谢尔曼（Scott Sherman）的赞助下，培训计划利用了VA纽约港医疗保健系统（HCS），纽约大学的资源，以及NIH赞助的纽约肥胖肥胖营养研究中心，结合了正式的课程，定向阅读和经验元素。该计划涉及关键领域的指导和教学教学，包括定性方法，行为改变理论，实施科学，临床试验设计和实施，肥胖创新，数字媒体设计，高级统计分析，赠款写作和研究传播。 Jay博士提出了一个三步项目，以增强VA MOVE！23软件应用程序，以便它可以用作目标设定干预措施的一部分，以治疗初级保健中的肥胖症。然后，她将评估这种干预措施，以便可以采用它为更广泛的初级保健退伍军人人口服务。在形成阶段，她将使用定性方法来告知此举！23软件和干预措施的开发。在开发阶段，她将增强MOVE！23软件应用程序，并开发干预措施的其他组件。然后，她将申请临床转化科学机构（CTSI）和/或基金会赠款，以帮助支持 她项目的评估阶段。在评估阶段，她将在纽约州纽约港HCS初级保健诊所进行试点研究，以测试可行性，可接受性并探索此干预措施的初步结果。她还将探索可行性的差异 并在将电话咨询添加到干预措施中时的结果。她将招募140个主题。所有受试者都将获得增强的举动！23，患者对齐护理团队（PACT）咨询。然后，他们将被随机分为两个干预武器：仅协议咨询或协定咨询以及其他电话咨询支持。她将探索在每个手臂内和12个月前和12个月的可行性，可接受性以及中级，行为和体重减轻结果的差异，并比较两个干预臂。该研究和培训计划将生成试点数据，以开发出色的审查应用程序，以进行三臂随机对照试验的干预措施。 公共卫生相关性： 项目叙述肥胖症的高流行及其对退伍军人健康的负面影响使得治疗和预防肥胖是退伍军人卫生管理局的高优先事项，因为适度的体重减轻可以预防和改善慢性疾病。不幸的是，创新的VA肥胖治疗计划，例如Move！不要到达大多数合格的退伍军人。初级保健是提供与肥胖相关服务并增加获得肥胖症护理的重要场所，但是，在这种情况下几乎没有有效的干预措施。杰伊博士 建议使用质量方法来增强现有的MOVE！23软件，以作为简短，计算机辅助的基于计算机的初级保健干预措施的一部分，以治疗肥胖和改善退伍军人健康。然后，她将进行试点研究以评估初步结果。