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Managing Obesity by Leveraging Health Information Technology to Lower Cancer Risk

利用健康信息技术控制肥胖以降低癌症风险

基本信息

批准号：
10355938
负责人：
KAREN C JOHNSON
金额：
$ 63.91万
依托单位：
UNIVERSITY OF TENNESSEE HEALTH SCI CTR
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-01-14 至 2026-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10355938
关键词：
Address Adult Affect Area Behavior Therapy Behavioral Body Weight Changes Body Weight decreased Caring Clinical Practice Guideline Clinical Trials Communities Diabetes Mellitus Diet Disease Effectiveness Electronic Health Record Enrollment Funding Goals Group Practice Guidelines Health Health Personnel Health Sciences Healthcare Systems Incidence Intervention Intervention Studies Low income Malignant Neoplasms Medical Methodist Church Methods Minority Groups Modeling Obesity Obesity associated cancer Outcome Overweight Participant Patients Persons Physical activity Physicians Population Population Group Private Sector Protocols documentation Public Sector Randomized Randomized Clinical Trials Research Research Personnel Research Project Grants Research Proposals Resources Risk Risk Factors Rural Population Site Support System System Target Populations Technology Telephone Tennessee Testing Time Touch sensation Training Translating Underserved Population United States United States National Institutes of Health Universities Weight Gain Weight maintenance regimen Work adult obesity base behavior change cancer risk cancer type clinical practice comparison group comparison intervention cost effective ethnic minority population formative assessment group intervention health care availability health disparity health information technology health plan healthcare community healthy lifestyle high risk innovation lifestyle intervention low socioeconomic status minority health disparity obesity management obesity risk obesity treatment patient health information patient portal prevent primary care setting primary outcome racial and ethnic racial minority rural area rural setting social social health determinants socioeconomics success tool uptake urban area urban setting weight loss intervention weight loss program

项目摘要

Obesity is an important risk factor for many serious diseases including many types of cancer.2-36 In the United States, obesity disproportionally affects underserved population groups such as racial and ethnic minorities, persons with lower socioeconomic status, and persons living in rural areas.1,37,38 These underserved groups are also at increased risk for developing and dying from cancer.39-42 Large clinical trials, such as Look AHEAD (Action for Health in Diabetes), have shown that a multicomponent weight loss intervention combining diet, physical activity, and behavioral modification is effective in achieving long term weight loss which resulted in a lower incidence of obesity-related cancers.43-45 As a result, clinical practice guidelines recommend the delivery of obesity interventions in primary care settings. However, it is unknown if such weight loss interventions work well in underserved populations or in rural settings because of limited access to healthcare resources and community facilities for a healthy lifestyle and/or because the target population may have different cultural and social backgrounds. To overcome these specific barriers to implementing a weight loss intervention, we propose a practice- based clinical trial to translate the efficacious Look AHEAD Intensive Lifestyle Intervention (ILI) to underserved populations. In this project, we will modify the intervention to be delivered through Health IT specifically the patient portal in the electronic health record (EHR) and will work with the Methodist Medical Group to establish partnerships between the investigators and community stakeholders. This project tests whether the Look AHEAD Intensive Lifestyle Intervention (ILI) will result in significant weight loss when delivered through Health IT- EHR patient portal compared to a Comparison intervention. This project will be conducted in 2 stages: a formative assessment stage (Stage 1) and a clinical trial stage (Stage 2). During Stage 1, we will modify the interactive technology-based Look AHEAD ILI that we already developed for the TARGIT study (Active Intervention Group). We will also adapt the Look AHEAD Comparison condition (DSE group) for our Comparison condition.56 We will also optimize the protocol for acceptability in underserved populations and in a rural setting. During Stage 2, we will randomly assign 250 participants to either the Comparison Group or the Active Intervention Group to address the primary aim of testing the hypothesis that a multicomponent, behavioral weight loss intervention delivered through Health IT – EHR patient portal will lead to significantly greater weight loss 12 months after enrollment compared with a comparison group. Our Health IT-based intervention is potentially cost-effective and thus disseminable to any practice-based physician group with access to an EHR with a patient portal. We have chosen the Socio-ecological Model as our conceptual model to assist with understanding social determinants of health as related to the study intervention and weight loss.

肥胖是许多严重疾病的重要危险因素，包括许多类型的癌症。2-36在