Design and Evaluation of the Remote Intervention for Diet and Exercise (RIDE)

描述（由申请人提供）： 根据NIH的治疗建议，美国大部分成年人有资格接受减肥治疗，但传统的基于诊所的减肥治疗有许多局限性。例如，生活在农村社区的人和社会经济地位低的人获得保健设施的机会有限，但这些人中有不成比例的人将受益于服务。已使用基于互联网的减肥干预措施向这些人群提供服务，但这些“电子保健”干预措施受到一些限制，只能产生适度的减肥效果。与基于互联网的干预措施相关的局限性包括随着时间的推移互联网应用程序的使用减少;患者必须登录互联网以接收治疗建议，但很少有患者定期登录应用程序，这对治疗结果产生了负面影响。另一个限制是参与者输入互联网应用程序或向在线顾问报告的自我报告的食物摄入量，运动和体重数据的质量。自我报告的数据与错误相关，需要准确的数据来为参与者制定有效的治疗建议。最后，大多数应用程序依赖于患者和咨询师之间的异步通信，患者并不总是在合理的时间内（1到3天）收到个性化的治疗建议，这限制了建议导致行为改变和体重减轻的程度。拟议的试点和可行性项目的目的是测试饮食和运动远程干预（RIDE）电子健康应用程序在促进减肥方面与对照条件相比的功效。RIDE电子保健应用程序解决了上述基于互联网的干预措施的局限性。该应用程序依赖于新技术来收集参与者在自由生活环境中的近实时食物摄入量，体重和运动数据。这些数据几乎是实时传输给研究人员的：食物摄入数据是使用该实验室开发的远程食物摄影方法通过相机和蓝牙手机收集和传输的，体重数据每天使用相同的手机从浴室秤自动传输，加速度计用于收集通过互联网传输的运动数据。分析这些数据并及时向参与者发送个性化治疗建议，例如，每隔1到3天，使用手机。RIDE电子健康应用程序是基于学习和行为理论开发的，以最大限度地改变行为和减轻体重。这项研究的结果将对向获得医疗保健有限的患者提供负担得起的有效体重管理干预措施产生重大影响。 公共卫生相关性：拟议的研究将提供有关饮食和运动远程干预（RIDE）电子健康应用程序在促进减肥方面的有效性的重要信息。这些发现将对向获得医疗保健机会有限的人提供负担得起的体重管理服务产生重大影响，包括生活在农村社区和经济拮据的人。这些人中有不成比例的人将受益于体重管理服务，但一些障碍限制了获得服务的机会。RIDE电子健康应用程序克服了许多这些障碍，以及以前的电子健康减肥干预措施的局限性。

DESCRIPTION (provided by applicant): A large proportion of the adult population in the United States qualifies for weight loss treatment based on the NIH treatment recommendations, but traditional clinic-based weight loss treatments have a number of limitations. For example, access to healthcare facilities is limited among people living in rural communities and people of low socioeconomic status, yet a disproportionate number of these people would benefit from services. Internet-based weight loss interventions have been used to deliver services to these populations, but these "e-Health" interventions suffer from a number of limitations and produce only modest weight loss. The limitations associated with internet-based interventions include decreased use of the internet application over time; patients must logon to the internet to receive treatment recommendations, yet few patients regularly logon to the application and this negatively affects treatment outcome. An additional limitation is the quality of self-reported food intake, exercise, and body weight data that participants enter into the internet application or report to their online counselor. Self-reported data are associated with error and accurate data are needed to formulate effective treatment recommendations for participants. Lastly, most applications rely on asynchronous communications between the patient and the counselor, and patients do not always receive personalized treatment recommendations in a reasonable amount of time (1 to 3 days), which limits the extent to which the recommendations result in behavior change and weight loss. The purpose of the proposed pilot and feasibility project is to test the efficacy of the Remote Intervention for Diet and Exercise (RIDE) e-Health application at promoting weight loss compared to a control condition. The RIDE e-Health application addresses the limitations of internet-based interventions that are noted above. The application relies on novel technology to collect near real-time food intake, body weight, and exercise data from participants while they reside in their free-living environments. These data are transmitted to the researchers in near real-time: food intake data are collected and transmitted with camera and Bluetooth-enabled cell phones using the Remote Food Photography method that was developed by this laboratory, body weight data is automatically transmitted daily from a bathroom scale using the same phones, and accelerometry is used to collect exercise data that is transmitted via the internet. These data are analyzed and personalized treatment recommendations are sent to the participant in a timely manner, e.g., every 1 to 3 days, using the cell phones. The RIDE e-Health application was developed based on learning and behavioral theory to maximize behavior change and weight loss. The findings of this study will have significant implications for the affordable delivery of effective weight management interventions to patients with limited access to health care. PUBLIC HEALTH RELEVANCE: The proposed research will provide important information on the efficacy of the Remote Intervention for Diet and Exercise (RIDE) e-Health application at promoting weight loss. The findings will have significant implications for the affordable delivery of weight management services to people who have limited access to health care, including people who live in rural communities and those with financial limitations. A disproportionate number of these individuals would benefit from weight management services, but a number of barriers limit access to services. The RIDE e-Health application overcomes many of these barriers, as well as the limitations of previous e-Health weight loss interventions.