Individualized Expert Systems for Weight Management

描述(申请人提供)：超重和肥胖的流行程度 在过去的二十年里急剧增加。超重和肥胖， 第二大可预防死因，对公众健康构成重大威胁 挑战在于它增加了慢性病的风险，包括冠状动脉疾病 心脏病和各种原因造成的死亡。以临床为基础的体重计划 管理成本高昂，而且只为一小部分人服务。 基于人口的行为改变计划需要达到更大的影响 更具成本效益的高危人群百分比。初步研究 跨理论模型(TTM)在体重管理中的应用 提示该模型具有潜在的指导发展的潜力 多行为干预。这项快速通道提案的第一阶段包括 阶段匹配的、个性化的、 基于TTM的互动干预。可行性包括主动 招募60%的合格参与者(n=250)参加 随机临床试验和评价干预措施的可接受性 材料。计算机化专家系统干预和阶段匹配手册 主动向整个人口提供服务可能会对 有针对性的健康行为以及体重。以TTM为基础 将提供专家所指出的必要的理论框架 开发更有效和更具成本效益的干预措施。 建议的商业应用： 建议的基于TTM的专家系统权重管理干预能够 高招聘率、准确的评估和个性化的干预 在人口基础上产生高度影响的能力。我们设想了这样的互动 以相对较低的成本通过邮寄或 通过互联网或内部网。商业应用包括对医疗保健的营销 提供者，即管理型医疗组织和分担以下负担的雇主 医疗保健费用。

DESCRIPTION (Provided by applicant): The prevalence of overweight and obesity has increased dramatically over the last two decades. Overweight and obesity, the second leading preventable cause of death, poses a major public health challenge in that it increases the risk of chronic diseases, including coronary heart disease, and all-cause mortality. Clinic-based programs for weight management are costly and serve only a small percentage of individuals. Population-based behavior change programs are needed to reach larger percentages of at risk individuals more cost-effectively. Preliminary research on the application of the Transtheoretical Model (TTM) to weight management suggests that the model has the potential to guide the development of effective multiple-behavior interventions. Phase I of this Fast-Track proposal involves the customization and feasibility testing of a stage-matched, individualized, interactive intervention based on the TTM. Feasibility includes proactively recruiting 60 percent of eligible participants (n=250) to participate in a randomized clinical trial and evaluating acceptability of the intervention materials. Computerized expert system interventions and stage-matched manuals delivered proactively to entire populations can have unprecedented impacts on the targeted health behaviors as well as weight. Using the TTM as the basis will provide the theoretical framework that experts have indicated is necessary to develop more effective and cost-effective interventions. PROPOSED COMMERCIAL APPLICATION: The proposed TTM based expert system weight management intervention is capable of high recruitment rates, accurate assessment, and individualized interventions that have the ability to create high impact on a population basis. We envision such interactive technologies for entire populations delivered at relatively low costs through the mail or over the Internet or an Intranet. Commercial applications include marketing to healthcare providers, namely managed care organizations, and employers who share the burden of healthcare expenses.