Innovative Technology to Improve Patient Adherence to Weight Loss Recommendations

提高患者对减肥建议的依从性的创新技术

• 批准号: 7821734
• 负责人: Rena R Wing
• 金额: $ 48.59万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7821734
• 关键词: Accountability; Address; Adherence; Affect; American; Applications Grants; Area; Behavioral; Body Weight; Body Weight decreased; Characteristics; Clinical; Computers; Control Groups; Counseling; Data; Diet; Education; Educational process of instructing; Elements; Feedback; Goals; Health; Health Benefit; Health behavior; Individual; Internet; Link; Maintenance; Measures; Medical; Modeling; Monitor; Morbidity - disease rate; Obesity; Online Systems; Outcome; Overweight; Participant; Patient Self-Report; Patients; Performance; Physical activity; Physicians; Play; Public Health; Published Comment; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recommendation; Records; Reporting; Research; Resources; Role; Suggestion; System; Technology; Testing; Time; Training; Treatment Protocols; Visit; Weight; Weight maintenance regimen; Writing; base; behavior change; compliance behavior; computer generated; cost; design; experience; follow-up; improved; innovation; innovative technologies; mortality; new technology; programs; skills; web site

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (06)-Enabling Technologies and Specific Challenge Topic 06-OD(OBSSR)-101* Using new technologies to improve or measure adherence. Overweight/obesity is a major health problem that affects over two-thirds of Americans, increases morbidity and mortality and has annual medical costs exceeding $75 billion. Although many Americans indicate that they are trying to lose weight, adherence to weight loss regimens is often poor. Programs are needed that can improve adherence and weight loss for overweight/obese individuals. Physicians play an important role in motivating patients to improve health behaviors and recent reviews suggest that having physicians advise patients to lose weight and then referring patients to an effective program produces the best behavior change and maintenance. The problem, however, is that physicians currently have limited options for such referrals. The challenge for the field is to develop a program to which physicians can refer their overweight/obese patients. The program must be low cost, easily accessible, and must promote adherence to the weight loss regimen and consequently improve weight loss outcomes. The goal of this Challenge Grant application is to develop and test an innovative web-based program that would provide an accessible and effective approach to enhancing adherence to clinical recommendations for weight loss. If effective, the program would provide an outstanding resource for physicians and their patients and could consequently have important clinical and public health impact. We propose to develop a program based on our prior research that uses innovative Internet technology to provide a low cost, easily disseminated program that captures two critical elements of effective behavioral weight loss programs-namely, training in key behavioral weight control strategies and increased participant accountability. Patients, referred by their physician for weight loss, will be offered a 12 week program that they can view at their convenience on their computer. The program will use Web-based interactive multi-media approaches for presentation of the behavioral skills and provide a Web-based form for submission of self- monitoring and weight data; to maximize patient accountability, the program will include a system of automated feedback for participants, which comments on their weight loss to date and their performance within several behavioral weight-loss domains, with suggestions tailored to the characteristics and performance of the individual. Periodic reports on the patients' progress will also be sent to the referring physician. We will test this program in a randomized trial with 250 patients referred by their physicians who will be randomly assigned to either Internet Education (Control) (N=125) or to the Innovative Technology program (N=125). Participants in both groups will receive a 12 week Internet program of either basic weight loss education or the Innovative Technology program and will be weighed at the start and end of the 3 month program and at 3 month follow- up. The primary hypothesis is that patients who are assigned to the Innovative Technology program will achieve larger average weight losses than those in the control group over the 12-week program. Secondary hypotheses are that the Innovative technology group will adhere better over the 12-weeks (assessed by log-ins to the web site and self-reported changes in diet and activity) and achieve better weight losses at 6 months than the control group. The proposed project addresses the significant problem of obesity and uses innovative technology to improve adherence to a behavioral weight loss strategies. If the program is effective, it would provide an outstanding resource for physicians to use with their patients and thus would have tremendous clinical impact. The proposed project addresses the significant problem of obesity and uses innovative technology to improve adherence to a behavioral weight loss strategies. If the program is effective, it would provide an outstanding resource for physicians to use with their patients and thus would have tremendous clinical impact.

描述（由申请人提供）：此申请解决广泛的挑战领域（06） - 提高技术和特定挑战主题06-OD（obssr）-101*使用新技术改善或衡量依从性。超重/肥胖是一个主要的健康问题，会影响超过三分之二的美国人，提高发病率和死亡率，并且年度医疗费用超过750亿美元。尽管许多美国人表明他们正在尝试减肥，但遵守减肥方案通常很差。需要计划，以改善超重/肥胖个体的依从性和体重减轻。医师在激励患者改善健康行为方面发挥着重要作用，最近的评论表明，让医生建议患者减肥，然后将患者转介有效计划会产生最佳的行为改变和维持。但是，问题是医生目前对此类转诊的选择有限。该领域面临的挑战是制定一个计划，医生可以将其超重/肥胖患者推荐。该计划必须是低成本，易于访问，并且必须促进遵守减肥方案，从而改善减肥结果。此挑战授予应用程序的目的是开发和测试一个基于Web的创新程序，该程序将提供一种可访问有效的方法，以增强依从性减肥建议。如果有效，该计划将为医生及其患者提供出色的资源，因此可能会对临床和公共卫生产生重要的影响。我们建议根据我们先前的研究制定一项计划，该计划使用创新的互联网技术提供低成本，易于传播的计划，该计划捕获了有效行为减肥计划的两个关键要素，即对关键行为重量控制策略进行培训，并提高参与者的责任感。由医生转诊以减轻体重的患者，将提供一个为期12周的计划，他们可以在计算机上进行便利。该计划将使用基于Web的交互式多媒体方法来介绍行为技能，并提供基于Web的形式，以提交自我监控和权重数据；为了最大程度地提高患者问责制，该计划将包括一个为参与者的自动反馈系统，该系统评论了他们迄今为止的体重减轻以及在几个行为减肥域中的表现，并针对个人的特征和表现量身定制。有关患者进度的定期报告也将发送给参考医师。我们将在一项随机试验中测试该计划，由250名由其医生转介的患者被随机分配到互联网教育（控制）（n = 125）或创新技术计划（n = 125）。两组的参与者将获得一个为期12周的基本减肥教育或创新技术计划的互联网计划，并将在3个月计划的开始和结束时进行权衡，并在3个月的随访中进行权衡。主要的假设是，被分配到创新技术计划的患者将获得比对照组对12周计划的患者的平均体重减轻。次要假设是，创新的技术小组将在12周内更好地粘附（通过日志评估到网站上，并自我报告的饮食和活动变化），并在6个月时实现比对照组更好的体重减轻。拟议的项目解决了肥胖的重大问题，并使用创新技术来提高对行为减肥策略的依从性。如果该计划有效，它将为医生与患者一起使用的出色资源，从而产生巨大的临床影响。拟议的项目解决了肥胖的重大问题，并使用创新技术来提高对行为减肥策略的依从性。如果该计划有效，它将为医生与患者一起使用的出色资源，从而产生巨大的临床影响。