Telehealth delivery of a weight loss program in diabetes

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DESCRIPTION (provided by applicant): Obesity and Type 2 diabetes are emerging epidemics in the U.S. Weight loss improves diabetes outcomes and reduces the need for anti-diabetic medication. However, implementation of behavioral weight loss programs in a primary care setting has proven to be a challenge. Internet-based weight loss programs have been shown to be effective, however, access to personal computers is limited among elderly and low-income populations. Additionally, computers require a degree of technical sophistication and access to the Internet poses a barrier for a significant portion of the at-risk diabetes population. A solution is required that offers the benefits of Internet-based weight loss programs without the technical challenges or cost. The overall goal of this study is to explore the human engineering issues of a home-based telehealth system, Healthium, utilizing an interactive television system over a broadband connection. The telehealth system to be tested support audio and video communications (synchronous or asynchronous), medical reminders, physiological monitoring (e.g. body weight) and diagnostic devices (e.g. glucometers), on screen health status tracking, patient education (audio, text and multimedia), and interactive health surveys. The program will be based on Internet-aided behavioral weight loss programs previously developed by the investigators. The proposed project will demonstrate how a diet and exercise program can be conducted with patients in their home via a television set and using the TV remote control. If the content can be successfully transposed from a PC/Internet environment to an interactive television platform, we would be able to demonstrate a convenient, intuitive and inexpensive way to conduct large-scale interventions related to obesity and nutrition. This could lead to a viable public health care initiative for prevention of obesity-associated chronic diseases. The Specific Aims to be addressed in this proposal are: 1) To transfer a successful Internet-based weight loss program onto the Healthium interactive platform and further develop the intervention for use in patients with Type 2 diabetes. 2) To conduct focus groups to determine consumer acceptance of the convenience and intuitiveness of the Healthium interface. 3) To perform a pilot study in patients with Type 2 diabetes to determine whether the Healthium interface improves weight loss and diabetes outcomes relative to standard clinic-based treatment.