Mobile Health Obesity Wellness Intervention in Rural Adults

农村成年人的移动健康肥胖健康干预

• 批准号: 10250588
• 负责人: John A. Batsis
• 金额: $ 11.4万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-15 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10250588
• 关键词: Address; Adult; Affect; Aging; Area; Award; Behavior Therapy; Behavioral; Body Weight decreased; Body fat; Caring; Chronic Disease; Clinical; Clinical Trials; Communities; Counseling; Data; Data Set; Development; Devices; Disease; Distant; Effectiveness; Elderly; Epidemiology; Exercise; Extramural Activities; Feasibility Studies; Feedback; Focus Groups; Future; General Population; Goals; Grant; Health; Health Care Costs; Health Promotion; Health Services; Health Status; Health Technology; Health behavior change; Healthcare; Home environment; Impairment; Individual; Intervention; Intervention Studies; Interview; K-Series Research Career Programs; Knowledge; Lead; Life; Measures; Medical; Mentors; Methods; Monitor; Muscular Atrophy; Nursing Homes; Nutritional; Obesity; Obesity Epidemic; Older Population; Outcome; Patient Self-Report; Patients; Persons; Physical Fitness; Physical Function; Physical activity; Pilot Projects; Population; Quality of life; Reproducibility; Research; Research Personnel; Risk; Rural; Rural Population; Sampling; Self-Direction; Services; Structure; Technology; Telemedicine; Testing; Time; Training; Transportation; Travel; Underserved Population; Videoconferencing; Weight; Wellness Program; Work; adult obesity; aging demographic; arm; base; bone; bone mass; cardiometabolic risk; career; clinically significant; disability; frailty; functional disability; functional outcomes; health care quality; high risk; human old age (65+); improved; improved functioning; improved mobility; innovative technologies; mHealth; mortality; multidisciplinary; muscle form; muscle strength; novel; nutrition; obesity management; obesity treatment; patient oriented; physical therapist; prevent; primary outcome; program dissemination; programs; remote sensing; remote sensor; resistance exercise; rural area; sarcopenia; sensor; sensor technology; skills; telehealth; usability; weight loss program

PROJECT SUMMARY: The national epidemic of obesity is also affecting older adults, and is associated with an increased risk of functional impairment, nursing home placement and early mortality. Conventional weight loss programs have the potential to reduce body fat, but are difficult to access for older obese adults due to transportation and mobility challenges. They may also lead to a detrimental loss of muscle and bone, paradoxically resulting in increased disability. The overarching goal of this Mentored Career Development Award is to develop the skills to become an independent researcher in community-based translational geriatric obesity research integrating innovative technology including mobile Health (mHealth), sensors, and video-conferencing with behavioral management to improve physical function. I will build upon the knowledge gained in my prior work using descriptive research to acquire the necessary skills and knowledge in this 5-year award to become an independent R01 investigator in geriatric obesity interventions research. Mentored activities, training, and coursework in key content areas will include: clinical trial methods (qualitative and quantitative); delivery of community-based obesity interventions using applied methods of telemedicine in rural populations; and enhancing health promotion using mHealth and sensors to facilitate behavioral change in older obese adults. Concurrently, I will conduct a program of pilot research aimed at developing and evaluating a technology assisted wellness intervention for obese older adults. First, I propose to assess the acceptability, usability, utility and perceived value of mHealth technology for obese older adults using a novel, adaptable mHealth device (Amulet) with remote sensing and self-monitoring capabilities, including strength, function, activity type, and real-time feedback (Qualitative assessment and Adapting Amulet). Second, I will conduct a single-arm, pilot feasibility study evaluating the potential effectiveness of a mHealth obesity wellness intervention (MOWI) for older obese adults in improving physical function (Develop & Refine MOWI). MOWI integrates Amulet with a weekly individual dietician-led nutritional session, along with twice weekly physical therapist led group exercise session. I will pilot test MOWI in a research-based setting over a 3-month period, and then deliver the intervention in the home setting using video-conferencing over a 6-month period (Evaluate Home MOWI). The primary clinical outcome is physical function, measured by observed muscle strength, observed physical fitness, and observed and self-reported life-task functioning. Secondary (exploratory) outcomes will include behavioral activation, objective physical activity, subjective health status, and subjective physical activity. The findings on the feasibility, acceptability, and preliminary estimates of effectiveness will be used in a future competitive application for an extramural R01 assessing the effectiveness of a home Telehealth-delivered MOWI in improving physical function in high-risk obese older adults as compared to an in-person intervention.

项目摘要： 肥胖的民族流行也正在影响老年人，并且与增加的风险有关 功能障碍，疗养院安置和早期死亡率。传统的减肥计划有 减少体内脂肪的潜力，但由于运输和 移动性挑战。它们也可能导致肌肉和骨骼的有害丧失，矛盾地导致 残疾增加。这个指导职业发展奖的总体目标是发展技能 成为基于社区的转化老年肥胖研究的独立研究人员 创新技术，包括移动健康（MHealth），传感器和视频会议的行为会议 管理以改善身体功能。我将基于我先前的工作中获得的知识 描述性研究以获取该五年奖励中必要的技能和知识，以成为 老年肥胖干预研究中的独立R01研究者。指导的活动，培训和 关键内容领域的课程将包括：临床试验方法（定性和定量）；交付 基于社区的肥胖干预措施使用农村人群中远程医疗的应用方法；和 使用MHealth和传感器增强健康促进，以促进老年肥胖成年人的行为改变。 同时，我将进行一项试点研究计划，旨在开发和评估技术 肥胖老年人的辅助健康干预。首先，我建议评估可接受性，可用性， MHealth技术对肥胖老年人的实用性和感知的价值，使用小说，适应性的MHealth 具有遥感和自我监控功能的设备（护身符），包括强度，功能，活动类型， 和实时反馈（定性评估和适应护身符）。第二，我将进行一臂， 试验可行性研究评估MHealth肥胖健康干预（MOWI）的潜在有效性（MOWI） 适用于肥胖的成年人改善身体机能（开发和完善MOWI）。 Mowi将护身符与 每周由营养师主导的营养课程，以及每周两次的物理治疗师LED小组 锻炼会议。我将在3个月的基于研究的环境中进行测试MOWI，然后交付 在6个月内使用视频会议进行干预（评估Home Mowi）。这 主要的临床结局是身体机能，通过观察到的肌肉力量来衡量，观察到的物理 健身，观察和自我报告的生活任务功能。次级（探索性）结果将包括 行为激活，客观的身体活动，主观健康状况和主观体育锻炼。这 关于可行性，可接受性和有效性的初步估计的结果将在未来使用 竞争性申请室外R01评估家庭远程医疗服务的有效性 与面对面的干预相比，Mowi改善了高危肥胖老年人的身体机能。