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）：残疾人的健康状况较差，与普通人群相比，肥胖率更高。对于美国超过5400万残疾人，管理不良的医疗保健风险明显更高。据估计，2006年，国家残疾相关的医疗保健支出（DAHE）为3979亿美元，占国家医疗保健支出的26.7％。问题更加复杂的是缺乏了解训练有素的促进专业人员，他们了解残疾人的健康需求，并能够为这个服务不足，脆弱的人群提供足够的服务。当医生和其他医疗保健提供者确定残疾患者的健康问题时，目前无处可寻 推荐他们的患者获得个性化的支持服务。没有定制的健康促进递送系统可以指导一个残疾人，例如减肥或维持体重减轻中的脊髓损伤，使这个服务不足的人口极易受到肥胖，不活动和营养不良的健康影响。该应用是响应RFA PA-11-335（实验室到市场：生物医学和行为研究工具），这是一项特殊的2年I阶段SBIR计划，旨在加速行为研究从学术研究到市场的翻译。该项目基于在过去15年中建立的康复，残疾信息学和健康促进方面的广泛研究结果和专业知识，并在我们在伯明翰阿拉巴马大学的CO-PI的詹姆斯·里默（James Rimmer）领导下，在促进残障人士的大量资金中建立了大量联邦资金。 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).我们的总体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，证明了身体残障人士的体重减轻，该建议旨在开发基于网络的个性化在线体重和锻炼响应系统（Powers），这是一种智能的个性化体重管理教练解决方案和专门针对残障人士设计的临床决策支持系统。其目标用户是从事临床中心，残疾人和卫生专业人员在公共卫生计划，康复专业人员和健身专业人员工作的健康促进专家，他们将充当“远程医疗教练”，以帮助残疾人实现体重减轻并改善其健康促进行为（改善营养和增加营养和增加活动）。预计由力量支持的计划的参与者将具有1）更大的体育锻炼和营养行为； 2）减少体育锻炼和健康饮食模式的障碍数量； 3）对体育锻炼和健康营养的态度的改善；最终4）重量和体重指数的减少更大。该阶段I项目具有三个具体的目标：1）从24个利益相关者那里收集有关系统功能，可用性设计以及通过焦点小组和访谈感知的有用性的反馈； 2）通过以用户为中心的设计过程扩展力量原型，包括两个正式的可用性测试，涉及12名卫生专业人员和12名残疾人； 3）进行PILO随机研究，以研究60名受试者的这种方法的功效和可行性。