Tailored telehealth weight management tool to overweight adults with disabilities

为超重残疾成人量身定制的远程医疗体重管理工具

• 批准号: 8454898
• 负责人: DerShung Yang
• 金额: $ 34.99万
• 依托单位: BRIGHTOUTCOME INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-20 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8454898
• 关键词: Address; Adult; Alabama; American; Attitude; Behavior; Behavioral; Behavioral Research; Biomedical Research; Body Weight decreased; Body mass index; Centers for Disease Control and Prevention (U.S.); Clinical; Clinical Decision Support Systems; Clinical Trials; Clinics and Hospitals; Complex; Continuity of Patient Care; Development; Diet; Disabled Persons; Eating; Effectiveness; Energy Metabolism; Exercise; Expert Systems; Family member; Fatty acid glycerol esters; Feedback; Fitness Centers; Focus Groups; Funding; General Population; Generations; Goals; Group Interviews; Health; Health Expenditures; Health Food; Health Personnel; Health Professional; Health Promotion; Health Promotion and Education; Health Status; Healthcare; Home environment; Individual; Informatics; Intervention; Leadership; Left; Life Style; Maps; Marketing; Modeling; Monitor; Muscle; Nutritional; Obesity; Online Systems; Outcome; Overweight; Participant; Patients; Pattern; Performance; Persons; Phase; Physical activity; Physicians; Pilot Projects; Population; Process; Public Health; Randomized; Recommendation; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Rest; Risk Factors; Services; Small Business Innovation Research Grant; Solutions; Specialist; Spinal cord injury; Support System; Surveys; System; Testing; Text; Translations; Underserved Population; Universities; Vulnerable Populations; Weight; Weight maintenance regimen; Work; base; cost; design; disability; evidence base; experience; fitness; health care delivery; high risk; improved; nutrition; programs; prototype; public health relevance; residence; response; telehealth; tool; usability

DESCRIPTION (provided by applicant): People with disabilities experience poorer health and have much higher rates of obesity compared to the general population. For the more than 54 million individuals with disabilities in the U.S., there is a significantly higher risk of poorly managed health care. It is estimated that the total national disability-associated health care expenditures (DAHE) were $397.9 billion in 2006, representing 26.7 percent of national health care spending. Compounding the problem is the lack of trained health promotion professionals who understand the health needs of adults with disabilities and are able to provide adequate services for this underserved, vulnerable population. When physicians and other healthcare providers identify health issues in patients with disabilities, there is currently nowhere they can refer their patients for individualized support services. There is no customized health promotion delivery system that can guide a person with a disability such as spinal cord injury in losing or maintaining weight, leaving this underserved population highly vulnerable to the health effects of obesity, inactivity and poor nutrition. This application is in response to RFA PA-11-335 (Lab to Marketplace: Tools for Biomedical and Behavioral Research), a special 2-year Phase I SBIR program to accelerate the translation of behavioral research from academic to the marketplace. The project is based on the extensive research results and expertise in rehabilitation, disability informatics, and health promotion established over the last 15 years with substantial federal funding for promoting health among people with disabilities under the leadership of Dr. James Rimmer, our co-PI at the University of Alabama at Birmingham. This application relies heavily on evidence-based research funded by the CDC for lifestyle weight management for adults with disabilities (particularly, the "Personalized Exercise Program" (PEP) projects: #R04CCR518810 and #R01DD000134) and disability informatics as part of the CDC-funded National Center on Health, Physical Activity and Disability (#U59DD000437). Our overarching goal is to promote the health of people with disabilities. As the result of obtaining successful outcomes from these projects demonstrating weight loss in people with physical disabilities, this proposal aims to develop a web-based Personalized Online Weight and Exercise Response System (POWERS), an intelligent individualized weight management coaching solution and clinical decision support system designed specifically for individuals with disabilities. Its target users are health promotion specialists working in clinical centers, disability and health professionals working in public health programs, rehabilitation professionals, and fitness professionals, who would serve as "telehealth coaches" to assist individuals with disabilities achieve weight loss and improve their health promotion behaviors (improved nutrition and increased physical activity). Participants in the POWERS-supported program are expected to have 1) greater increase in physical activity and nutritional behaviors; 2) greater reduction in the number of barriers to physical activity and healthy eating patterns; 3) greater improvement in attitudes toward physical activity and healthy nutrition; and ultimately 4) greater reduction in weight and Body Mass Index. This Phase I project has three specific aims: 1) collect feedback from 24 stakeholders on system features, usability design, and perceived usefulness via focus groups and interviews; 2) extend the POWERS prototype with a user- centric design process including two formal usability tests involving 12 health professionals and 12 individuals with disabilities; and 3) conduct a pilo randomized study to study the efficacy and feasibility of this approach with 60 subjects.

描述（由申请人提供）：与普通人群相比，残疾人的健康状况较差，肥胖率高得多。对于美国5400多万残疾人来说，保健管理不善的风险要高得多。据估计，2006年全国与残疾有关的保健支出总额为3，979亿美元，占全国保健支出的26.7%。使问题更加复杂的是，缺乏训练有素的健康促进专业人员，他们了解成年残疾人的健康需求，能够为这一得不到充分服务的弱势群体提供适当服务。当医生和其他医疗保健提供者发现残疾患者的健康问题时，目前他们没有办法 将患者转介至个性化支持服务。没有定制的健康促进提供系统可以指导脊髓损伤等残疾人减肥或保持体重，使这一得不到充分服务的人口极易受到肥胖、缺乏活动和营养不良的健康影响。该申请是对RFA PA-11-335（实验室到市场：生物医学和行为研究工具）的响应，这是一个为期2年的第一阶段SBIR计划，旨在加速行为研究从学术到市场的转变。该项目是基于广泛的研究成果和专业知识，在康复，残疾信息学和健康促进建立了在过去的15年中，大量的联邦资金用于促进健康的残疾人的领导下，詹姆斯里默博士，我们的共同PI在伯明翰的亚拉巴马大学。该应用程序在很大程度上依赖于由CDC资助的基于证据的研究，用于残疾成年人的生活方式体重管理（特别是“个性化运动计划”（PEP）项目：#R04CCR 518810和#R01DD000134）和残疾信息学，作为CDC资助的国家健康，身体活动和残疾中心的一部分（#U59DD000437）。我们的首要目标是促进残疾人的健康。由于从这些项目中获得成功的结果，证明了身体残疾人的体重减轻，本提案旨在开发基于网络的个性化在线体重和运动响应系统（POWERS），这是一种专门为残疾人设计的智能个性化体重管理辅导解决方案和临床决策支持系统。其目标用户是在临床中心工作的健康促进专家、在公共卫生方案工作的残疾和健康专业人员、康复专业人员和健身专业人员，他们将担任“远程保健教练”，帮助残疾人实现减肥和改善其健康促进行为（改善营养和增加体育活动）。参与POWERS支持的计划的参与者预计将：1）身体活动和营养行为增加更多; 2）身体活动和健康饮食模式障碍的数量减少更多; 3）对身体活动和健康营养的态度有更大的改善;最终4）体重和体重指数减少更多。第一阶段项目有三个具体目标：1）通过焦点小组和访谈收集24个利益相关者对系统功能、可用性设计和感知有用性的反馈; 2）以用户为中心的设计过程扩展POWERS原型，包括两个正式的可用性测试，涉及12名健康专业人员和12名残疾人;（3）对60名受试者进行了一项初步随机研究，以研究这种方法的有效性和可行性。