Web-Based Delivery of MOVE! to Veterans With Serious Mental Illness

基于网络的 MOVE! 交付

基本信息

批准号：
8195243
负责人：
RICHARD Warren GOLDBERG
金额：
--
依托单位：
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-01 至 2013-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8195243
关键词：
Address Adult Adverse effects Ambulatory Care Facilities Area Baltimore Bipolar Disorder Caring Cessation of life Chronic Disease Clinic Clinical Cognitive Cognitive Therapy Communities Computer Assisted Computers Control Groups Counseling Diet Diet Habits Disease Education Educational Curriculum Effectiveness Epidemic Evidence based intervention Evidence based practice Evidence based treatment Funding Guidelines Health Health Care Costs Health Promotion Healthcare Individual Inferior Informatics Internet Intervention Interview Learning Learning Disabilities Life Expectancy Location Medical Medical center Mental Health Mental disorders Methods Motivation Nutritionist Obesity Online Systems Outcome Overweight Participant Patients Personal Communication Persons Pharmaceutical Preparations Physical activity Population Primary Health Care Psyche structure Quality of life Randomized Controlled Trials Readiness Reporting Research Research Personnel Resources Risk Schedule Schizophrenia Self Efficacy Services Site System Technology Testing Time Transportation Travel United States Veterans Visit Weight Weight Gain Weight maintenance regimen abstracting base computerized control trial cost design diet and exercise disorder prevention evidence base experience improved literacy meetings mortality nutrition education preference programs prospective prototype psychoeducational psychoeducational intervention psychotic depression rural area severe mental illness success treatment strategy urban area web site

项目摘要

Abstract Background/Rationale: Obesity has reached epidemic proportions, and often has serious adverse health consequences. The VA has been deploying a "MOVE! Weight Management Program" nationally in the general veteran population. Since individuals with serious mental illness (SMI) usually have cognitive problems, specialized psychoeducational interventions are required in this population. Specialized psychoeducational interventions for weight have been developed and studied in populations with SMI. This evidence-based practice has been adapted for use in VA, resulting in a "MOVE! SMI" intervention. However, it has proven to be quite difficult to disseminate this intervention. Patients with SMI often have limited transportation options, and may not want to participate in groups. Also, in-person MOVE! SMI requires substantial time from mental health clinicians. This clinician time has been difficult to redeploy or not available at many VA locations. It is very likely that these barriers can be addressed with a computerized, web-based version of MOVE! that is tailored for veterans with SMI. Specialized web-based approaches have been studied and found to be successful in this population, and can deliver content that is intensive and engaging with minimal requirements for staff time. Objectives: The VISN 5 and 22 MIRECCs have developed a prototype web-based system that provides computerized counseling regarding diet to veterans with SMI. The proposed project will expand this system. This project's objectives are to: 1) develop a comprehensive web-based system that delivers MOVE! using design features that meet the needs of individuals with SMI; 2) evaluate the effectiveness, in veterans with SMI, of web-based MOVE! compared with in-person MOVE! and a control group; and, 3) characterize, from the patient's perspective, the strengths, weaknesses, and barriers to the use of in-person and web-based MOVE!. Methods: This is a prospective, randomized, controlled trial in 300 veterans with SMI who are overweight and receiving treatment with medications that often have weight gain as a major side-effect. Participants are assigned to in-person MOVE! SMI, web-based MOVE! SMI, or a control group. Research assessments occur at 0, 3, and 6 months. Changes in outcomes are compared over time between the three groups. Significance: By losing weight, veterans with SMI can decrease their risk for medical problems that have a serious negative effect on their quality of life and life expectancy. A web-based system that helps veterans lose weight could be feasible to disseminate broadly at VA sites, including medical centers and community based outpatient clinics serving both rural and urban areas.

抽象的背景/理由：肥胖症已经达到了流行比例，并且经常会带来严重的不良健康后果。 VA 在全国范围内的退伍军人人口中，一直在全国范围内部署一个“举动！体重管理计划”。由于患有严重精神疾病（SMI）的人通常有认知问题，因此该人群需要进行心理教育干预措施。专门的心理教育干预措施为了在患有SMI的种群中开发和研究重量。这种循证实践一直是适用于VA使用，从而进行了“ Move！SMI”干预。但是，事实证明很难传播这种干预措施。 SMI患者的运输方式通常有限，可能不想要参加小组。另外，面对面的举动！ SMI需要精神卫生临床医生的大量时间。这个临床医生很难重新部署或在许多VA地点不可用。很可能这些障碍可以通过计算机化的基于网络的Move来解决！这是为退伍军人量身定制的与smi。已经研究了专业的基于Web的方法，并发现在该人群中取得了成功，并可以提供密集的内容，并且可以对员工时间的要求很少。目标： VISN 5和22 MireCC已开发了一个基于Web的原型系统，可提供有关饮食对退伍军人的计算机咨询。拟议的项目将扩展该系统。该项目的目标是：1）开发一个基于Web的全面系统，可提供移动！使用满足SMI个人需求的设计功能； 2）评估SMI退伍军人的有效性，基于Web的移动！与面对面的举动相比！和对照组； 3）从患者的观点，优点，劣势和基于网络和基于Web的动作的障碍！方法：这是一项前瞻性，随机，对照的试验，在300名退伍军人中，SMI超重，接受通常具有体重增加作为主要副作用的药物治疗。参与者是分配给面对面的举动！ SMI，基于网络的举动！ SMI或对照组。研究评估发生在 0、3和6个月。随着时间的流逝，三组之间的结局变化将被比较。意义：通过减肥，患有SMI的退伍军人可以降低其医疗问题的风险对他们的生活质量和预期寿命的负面影响。一个基于网络的系统，可帮助退伍军人减肥在包括医疗中心和基于社区在内的VA网站上广泛传播可能是可行的为农村地区和城市地区提供服务的门诊诊所。