CoachToFit: Adapted Weight Loss Intervention for Individuals with Serious Mental Illness
CoachToFit:针对严重精神疾病患者的适应性减肥干预
基本信息
- 批准号:10247450
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-10-01 至 2024-09-30
- 项目状态:已结题
- 来源:
- 关键词:AddressAreaAwarenessBody Weight decreasedCaloriesCardiovascular systemCaringCellular PhoneChronic DiseaseClinicClinic VisitsClinicalCognitiveCognitive deficitsCoupledDiseaseDisease ManagementEducationEnrollmentEpidemicEvaluationEvidence based interventionFocus GroupsGeneral PopulationGoalsGrowthHealthHealth Care CostsHealth PromotionHealthcareHealthcare SystemsImprove AccessIndividualInformaticsInternationalInterventionInterviewLeadLeadershipLife ExpectancyMaintenanceMeasuresMedicalMedical centerMental HealthMethodological StudiesModelingMorbidity - disease rateMotivationObesityOnline SystemsOutcomeOverweightOwnershipPatient PreferencesPatientsPersonsPoliciesPopulationPopulation InterventionPositioning AttributeProcessProviderPublic Health InformaticsPublishingRandomizedRandomized Controlled TrialsReach Effectiveness Adoption Implementation and MaintenanceReadinessReportingResearchResearch DesignSamplingSelf EfficacyServicesSleeplessnessSpecialistTechnologyTelephoneTestingTimeTransportationUnited States Department of Veterans AffairsVeteransWeightWeight maintenance regimencare deliveryclinically significantcomorbiditycostdashboarddata visualizationdesigndiariesdiet and exercisedisorder preventioneHealtheducation accessefficacy outcomesefficacy testingevidence baseexperiencefuture implementationinnovationintervention deliverymHealthmembermobile computingmortalitymortality riskonline deliverypeerpeer supportphysical inactivitypost interventionprogramspsychosocialservice deliverysevere mental illnessskills trainingsmartphone Applicationtooltraditional caretreatment as usualtreatment grouptreatment guidelinestrendusabilityuser centered designweight loss intervention
项目摘要
Background: Between 40% to 60% of individuals with serious mental illness (SMI) are obese. Obesity and
physical inactivity result in increased rates of chronic diseases, increased risk of death, and substantial health
care costs. Treatment guidelines recommend that individuals with SMI who are overweight should be offered
evidence-based weight loss interventions, including psychosocial interventions. The VA’s weight management
program, MOVE!, is attended by less than 5% of the overweight population and is not adapted to the cognitive
needs and patient preferences for the population with SMI. Effective adapted weight management programs
are not offered in VA because they are time-intensive and require the skills of trained providers who are often
in short-supply. CoachToFit can address this gap in care. CoachToFit is a weight management program,
adapted for the population with SMI, that includes a smartphone app delivering evidence-based weight
management services with weekly telephonic support from a VA peer specialist who acts as a wellness coach.
Peer specialists are individuals who draw upon lived experiences with SMI to provide services to others with
SMI in clinical settings. CoachToFit was shown to have high rates of acceptability and usability and was
efficacious for weight loss in a small sample. VA has an opportunity to address obesity in the population with
serious mental illness, currently a substantial gap in care.
Significance/Impact: This project addresses obesity in the population with SMI by evaluating a weight
management program that is not only evidence-based, it is sustainable, transportable, appealing to patients,
easy to use, and minimally burdensome to the healthcare system. This effort addresses two HSR&D priority
areas: 1) Mental Health: Testing new models of care to improve access, cost, and/or outcomes, and 2) Health
Care Informatics: Building the evidence base for ehealth/mhealth tools.
Innovation: CoachToFit’s use of mobile technology is an important innovation in VA service delivery and its
user-centered design involving individuals with SMI was the first of its kind. CoachToFit is enhanced by data
visualization in real-time via a web-based dashboard used by VA peer specialists and their supervisor. We are
aware of no other evidence-based mobile platforms to help people with SMI reduce their weight.
Specific Aims: The project aims to 1) Test the efficacy of CoachToFit, compared to usual care, in decreasing
weight among Veterans with SMI who are obese; 2) Assess the hypothesized mechanisms of action for
CoachToFit, including self-efficacy, motivation, and readiness to change; and 3) Characterize factors that will
inform future implementation and maintenance of CoachToFit using a multi-stakeholder qualitative post-
intervention evaluation guided by the RE-AIM framework.
Methodology: The study design includes a randomized controlled trial to test the efficacy of CoachToFit and
assess the hypothesized mechanisms of action. This will include enrollment of obese Veterans with SMI from
the mental health clinics at one VA medical center (n=256). Individuals will be randomized to CoachToFit or
usual care. Those in CoachToFit will have access to the app and coaching for 6 months. Outcomes are assessed
at 6- and 12-months. Efficacy outcomes utilize objective measures. The design also includes a multi-
stakeholder qualitative post-intervention evaluation guided by the RE-AIM framework to characterize factors
that will inform future implementation and maintenance of CoachToFit. This will include interviews with
Veterans randomized to CoachToFit (n=30); interviews with staff stakeholders (n=18); a discussion with
Veterans in local Veteran groups (n=2 groups; n=11 Veterans), and interviews with national leadership (n=3).
Next Steps/Implementation: If CoachToFit is found to be efficacious, the VA National Center for Health
Promotion and Disease Prevention, along with input from national leadership in Peer Support Services and
Mental Health Informatics, will assist in integration into the VA context.
背景:40%到60%的严重精神疾病(SMI)患者肥胖。肥胖和
项目成果
期刊论文数量(0)
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会议论文数量(0)
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{{ truncateString('MATTHEW CHINMAN', 18)}}的其他基金
CoachToFit: Adapted Weight Loss Intervention for Individuals with Serious Mental Illness
CoachToFit:针对严重精神疾病患者的适应性减肥干预
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CoachToFit: Adapted Weight Loss Intervention for Individuals with Serious Mental Illness
CoachToFit:针对严重精神疾病患者的适应性减肥干预
- 批准号:
10625826 - 财政年份:2020
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