Mobile Health Obesity Wellness Intervention in Rural Older Adults_Res1

项目总结： 肥胖症的全国性流行也影响着老年人，并与患肥胖症的风险增加有关。 功能障碍、养老院安置和早期死亡率。传统的减肥计划有 有可能减少身体脂肪，但由于交通和交通原因，老年肥胖者很难获得 移动性挑战。它们还可能导致肌肉和骨骼的有害损失，矛盾的是导致 伤残增加。这个辅导式职业发展奖的首要目标是发展技能 成为社区翻译性老年肥胖研究的独立研究员 包括移动健康(MHealth)、传感器和视频会议在内的创新技术 管理，以提高身体机能。我将在我以前的工作中获得的知识基础上使用 描述性研究在这个为期5年的奖项中获得必要的技能和知识，以成为 老年肥胖干预研究中的独立R01调查员。有指导的活动、培训和 关键内容领域的课程将包括：临床试验方法(定性和定量)； 在农村人口中使用远程医疗的应用方法进行基于社区的肥胖干预；以及 使用mHealth和传感器加强健康促进，以促进老年肥胖成年人的行为改变。 同时，我将进行一项旨在开发和评估一项技术的试点研究计划 针对肥胖老年人的辅助健康干预。首先，我建议评估可接受性、可用性、 使用新的、可适应的mHealth对肥胖老年人使用mHealth技术的效用和感知价值 具有遥感和自我监控功能的设备(护身符)，包括强度、功能、活动类型、 和实时反馈(定性评估和适应护身符)。第二，我将进行单臂， 评估mHealth肥胖健康干预(MOWI)潜在有效性的试点可行性研究 为老年肥胖成年人改善身体功能(制定和完善MOWI)。MOWI将Aulet与 每周一次由营养师领导的个人营养会议，以及一周两次的物理治疗师领导的小组 健身房。我将在3个月的时间内在基于研究的环境中试行MOWI，然后交付 在6个月的时间内使用视频会议对家庭环境进行干预(评估家庭MOWI)。这个 主要临床结果是身体功能，通过观察到的肌肉力量来衡量，观察到的身体状况 健康，观察和自我报告的生活任务功能。次要(探索性)成果将包括 行为激活、客观体力活动、主观健康状况和主观体力活动。这个 关于有效性的可行性、可接受性和初步估计的结果将在未来使用 竞争性申请校外R01，评估家庭远程医疗的有效性 与面对面干预相比，MOWI在改善高危肥胖老年人身体功能方面的作用。

PROJECT SUMMARY: The national epidemic of obesity is also affecting older adults, and is associated with an increased risk of functional impairment, nursing home placement and early mortality. Conventional weight loss programs have the potential to reduce body fat, but are difficult to access for older obese adults due to transportation and mobility challenges. They may also lead to a detrimental loss of muscle and bone, paradoxically resulting in increased disability. The overarching goal of this Mentored Career Development Award is to develop the skills to become an independent researcher in community-based translational geriatric obesity research integrating innovative technology including mobile Health (mHealth), sensors, and video-conferencing with behavioral management to improve physical function. I will build upon the knowledge gained in my prior work using descriptive research to acquire the necessary skills and knowledge in this 5-year award to become an independent R01 investigator in geriatric obesity interventions research. Mentored activities, training, and coursework in key content areas will include: clinical trial methods (qualitative and quantitative); delivery of community-based obesity interventions using applied methods of telemedicine in rural populations; and enhancing health promotion using mHealth and sensors to facilitate behavioral change in older obese adults. Concurrently, I will conduct a program of pilot research aimed at developing and evaluating a technology assisted wellness intervention for obese older adults. First, I propose to assess the acceptability, usability, utility and perceived value of mHealth technology for obese older adults using a novel, adaptable mHealth device (Amulet) with remote sensing and self-monitoring capabilities, including strength, function, activity type, and real-time feedback (Qualitative assessment and Adapting Amulet). Second, I will conduct a single-arm, pilot feasibility study evaluating the potential effectiveness of a mHealth obesity wellness intervention (MOWI) for older obese adults in improving physical function (Develop & Refine MOWI). MOWI integrates Amulet with a weekly individual dietician-led nutritional session, along with twice weekly physical therapist led group exercise session. I will pilot test MOWI in a research-based setting over a 3-month period, and then deliver the intervention in the home setting using video-conferencing over a 6-month period (Evaluate Home MOWI). The primary clinical outcome is physical function, measured by observed muscle strength, observed physical fitness, and observed and self-reported life-task functioning. Secondary (exploratory) outcomes will include behavioral activation, objective physical activity, subjective health status, and subjective physical activity. The findings on the feasibility, acceptability, and preliminary estimates of effectiveness will be used in a future competitive application for an extramural R01 assessing the effectiveness of a home Telehealth-delivered MOWI in improving physical function in high-risk obese older adults as compared to an in-person intervention.