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.

项目概要： 肥胖症在全国范围内的流行也影响着老年人，并且与肥胖风险增加有关 功能障碍、疗养院安置和早期死亡。传统的减肥计划有 具有减少身体脂肪的潜力，但由于交通和运输的原因，老年肥胖者很难获得 流动性挑战。它们还可能导致肌肉和骨骼的有害损失，矛盾的是， 残疾增加。该指导职业发展奖的总体目标是培养技能 成为基于社区的转化型老年肥胖研究的独立研究员 创新技术，包括移动健康 (mHealth)、传感器和行为视频会议 管理以改善身体机能。我将利用之前工作中获得的知识来构建 描述性研究，以获得必要的技能和知识，在这个为期 5 年的奖项中成为一名 老年肥胖干预研究的独立 R01 研究者。指导活动、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 在农村人口中使用远程医疗应用方法进行基于社区的肥胖干预措施；和 使用移动医疗和传感器加强健康促进，以促进老年肥胖者的行为改变。 同时，我将开展一项试点研究计划，旨在开发和评估一项技术 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、 使用新颖、适应性强的移动医疗技术对肥胖老年人的实用性和感知价值 具有遥感和自我监控功能的设备（Amulet），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）。其次，我会进行单臂， 评估移动健康肥胖健康干预措施 (MOWI) 潜在有效性的试点可行性研究 针对老年肥胖者改善身体机能（Develop & Refine MOWI）。 MOWI 将 Amulet 与 每周一次由营养师主导的营养课程，以及每周两次由物理治疗师主导的小组 练习课。我将在 3 个月的时间内在基于研究的环境中对 MOWI 进行试点测试，然后交付 在 6 个月的时间内使用视频会议对家庭环境进行干预（评估家庭 MOWI）。这 主要临床结果是身体机能，通过观察到的肌肉力量、观察到的身体状况来测量 健康状况，以及观察和自我报告的生活任务功能。次要（探索性）成果将包括 行为激活、客观身体活动、主观健康状况和主观身体活动。这 关于可行性、可接受性和有效性初步估计的调查结果将在未来使用 校外 R01 的竞争性申请，评估家庭远程医疗服务的有效性 与面对面干预相比，MOWI 可改善高危肥胖老年人的身体功能。