MOVE!+UP: Improving MOVE! for Veterans with PTSD Using Peer Support

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• 批准号: 9789664
• 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: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9789664
• 关键词: Address; Affect; Area; Behavior Therapy; Behavioral; Behavioral Sciences; Binge Eating; Body Weight decreased; Buffers; Cardiovascular system; Caring; Chronic Disease; Clinical; Collaborations; Communities; Counseling; Data; Development Plans; Diet; Dietary Assessment; Dietary Intervention; Doctor of Philosophy; Effectiveness; Ensure; Funding; Goals; Health; Health Benefit; Health Care Costs; Health Services; Health behavior; Infrastructure; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Learning; Measurement; Mediator of activation protein; Mental Health; Mental Health Services; Mental disorders; Mentors; Methods; Names; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Overweight; Participant; Patient-Centered Care; Patients; Personal Satisfaction; Physical activity; Population; Post-Traumatic Stress Disorders; Premature Mortality; Preparation; Problem Solving; Process; Professional counselor; Provider; Psychiatry; Psychologist; Psychology; Public Health; Quality of life; Randomized Controlled Trials; Recovery; Reporting; Research; Research Personnel; Research Training; Risk; Sampling; Shapes; Social support; Symptoms; Telephone; Testing; Training; Training Support; Unhealthy Diet; Universities; Veterans; War; Washington; Weight; Weight maintenance regimen; Well in self; Work; anxiety management; base; burden of illness; cardiovascular risk factor; care costs; career; career development; community reintegration; efficacy testing; experience; follow-up; good diet; health care delivery; healthy lifestyle; implementation science; improved; medical specialties; nutrition; peer; peer support; physical conditioning; pilot trial; preference; prevent; primary outcome; professor; programs; psychologic; reduce symptoms; satisfaction; secondary outcome; skills; sound; treatment as usual; weight loss intervention

DESCRIPTION (provided by applicant): Background: Katherine Hoerster, PhD, MPH is a staff psychologist with VA Puget Sound-Seattle (VAPS) and Acting Assistant Professor with the University of Washington (UW) Department of Psychiatry and Behavioral Sciences. Dr. Hoerster has demonstrated a commitment to conducting VA research focused on improving the health and well-being of Veterans with PTSD. The proposed career development award (CDA-2) will ensure that Dr. Hoerster will develop the skills and expertise necessary to become an independent health services researcher dedicated to improving care for Veterans with psychiatric illness. Career Development Plan: The proposed CDA-2 is focused on studying a peer-led behavioral weight management intervention that augments VA's existing weight management program (MOVE!) for Veterans with PTSD: MOVE!+UP (Improving MOVE! for Veterans with PTSD Using Peer Support). MOVE!+UP will be delivered by a paid peer support counselor in 4 group sessions in the first month of MOVE!, and will involve learning basic anxiety management skills and engaging in community-based physical activity to address barriers (e.g., hypervigilance). Four biweekly brief telephone counseling sessions will take place after MOVE!+UP's group ends and will focus on maintaining gains and problem-solving barriers. This intervention is proposed because Veterans with PTSD experience 1) high rates of obesity and related conditions due to inactivity and unhealthy diet; 2) reduced effectiveness of MOVE!; and 3) unique barriers to physical activity and healthy diet. Social support buffers these barriers to physical activity and healthy diet for Veterans with PTSD, and Veterans with PTSD endorse a strong preference for working with peers on these issues. In addition to the potential health behavior and weight loss benefits, MOVE!+UP is also expected to address PTSD symptoms. The proposed CDA-2 involves two studies that will assess MOVE!+UP's acceptability and feasibility and guide its refinement: 1) an uncontrolled pilot trial and follow-up qualitative interviews among 28 obese Veterans with PTSD; and 2) qualitative interviews with a purposive sample of 12-16 VA providers and key stakeholders. The refined MOVE!+UP intervention will be tested in a randomized controlled trial (RCT) to determine whether MOVE!+UP leads to better weight loss than usual care MOVE! among 336 obese Veterans with PTSD. Dr. Hoerster will conduct the research and training under mentors and consultants expert in peer support and behavioral weight loss interventions (Karin Nelson, MD, MSHS), health behavior intervention RCTs (Gayle Reiber, PhD, MPH) and specifically those for Veterans with PTSD (Miles McFall, PhD), integrated care and implementation science (J¿rgen Un¿tzer, MD, MPH, MA), physical activity and dietary assessment and intervention (Brian Saelens, PhD), and qualitative (Helene Starks, PhD, MPH) and statistical (Dr. David Atkins, PhD) methods. Mentors and consultants are located at VAPS or UW. Dr. Hoerster will also participate in UW coursework, local and national trainings, national collaborations, and other academic and professional activities to support training goals. The CDA-2 research and training plan will provide essential preparation to advance Dr. Hoerster's independent research career in the following areas: 1) peer support approaches to promoting physical activity and diet; 2) interventions to address chronic disease in Veterans with psychiatric conditions; 3) RCTs for behavioral interventions; and 4) dissemination and implementation of behavioral interventions. Impact: This CDA-2 will accelerate Dr. Hoerster's independence as a VA health services investigator. Dr. Hoerster will focus on studying ways to reduce inequitable disease burden for Veterans with psychiatric conditions and use this research to shape VA mental health services delivery.

描述（由申请人提供）： 背景：凯瑟琳·霍斯特 (Katherine Hoerster) 博士、公共卫生硕士是西雅图 VA 普吉特海湾 (VAPS) 的一名专职心理学家，也是华盛顿大学 (UW) 精神病学和行为科学系的代理助理教授。Hoerster 博士致力于开展 VA。研究重点是改善患有创伤后应激障碍 (PTSD) 的退伍军人的健康和福祉 拟议的职业发展奖 (CDA-2) 将确保 Hoerster 博士发展成为致力于改善健康服务的独立卫生服务研究员所需的技能和专业知识。照顾患有精神疾病的退伍军人。 职业发展计划：拟议的 CDA-2 重点研究同伴主导的行为体重管理干预措施，以增强 VA 现有的针对患有 PTSD 退伍军人的体重管理计划 (MOVE!)：MOVE!+UP（改善） MOVE!+UP 将由付费同伴支持顾问在 MOVE! 的第一个月举办 4 场小组课程，其中包括学习基本的焦虑管理技能和参与MOVE!+UP 小组结束后，将举行四次每两周一次的简短电话咨询会议，重点关注维持成果和解决问题解决障碍，这是针对患有 PTSD 的退伍军人提出的。经验 1) 由于缺乏活动和不健康的饮食导致肥胖和相关疾病的发生率较高； MOVE! 的有效性降低；3) 身体活动和健康饮食的独特障碍，社会支持可以缓冲患有 PTSD 的退伍军人的这些身体活动和健康饮食障碍，并且患有 PTSD 的退伍军人强烈倾向于与同伴合作解决这些问题。除了潜在的健康行为和减肥益处外，MOVE!+UP 还有望解决 PTSD 症状。拟议的 CDA-2 涉及两项研究，将评估 MOVE!+UP 的可接受性和可行性并指导其完善：1) 一项研究。对 28 名患有 PTSD 的肥胖退伍军人进行非对照试点试验和后续定性访谈；2) 对 12-16 名 VA 提供者和主要利益相关者进行有目的的定性访谈，将在随机对照试验中测试改进的 MOVE!+UP 干预措施。 Hoerster 博士将在 336 名患有 PTSD 的肥胖退伍军人中进行随机对照试验，以确定 MOVE!+UP 是否比常规护理能带来更好的减肥效果。同伴支持和行为减肥干预（Karin Nelson，医学博士，MSHS），健康行为干预随机对照试验（Gayle Reiber，博士，公共卫生硕士），特别是针对患有创伤后应激障碍（PTSD）退伍军人的干预（迈尔斯·麦克福尔，博士），综合护理和实施科学（J¿ rgen Un¿找到了 Tzer（医学博士、公共卫生硕士、文学硕士）、身体活动和饮食评估和干预（布莱恩·塞伦斯（Brian Saelens）博士）以及定性（海伦·斯塔克斯（Helene Starks）博士、公共卫生硕士）和统计（大卫·阿特金斯博士）导师和顾问方法。 Hoerster 博士还将参加 VAPS 或华盛顿大学的课程作业、地方和国家培训、国家合作以及其他学术和专业活动，以支持 CDA-2 研究和培训计划。推进 Hoerster 博士在以下领域的独立研究事业：1) 促进身体活动和饮食的同伴支持方法；2) 解决患有精神疾病的退伍军人的慢性疾病；3) 行为干预的随机对照试验；影响：该 CDA-2 将加速 Hoerster 博士作为 VA 卫生服务调查员的独立性。 Hoerster 博士将专注于研究减少患有精神疾病和使用的退伍军人的不公平疾病负担的方法。这项研究旨在塑造退伍军人管理局心理健康服务的提供。