Personalized Physical Activity & Nutrition Intervention for Overweight/Obese.....

描述（由申请人提供）：制定有效和可持续的干预措施，以增加关键的健康行为仍然是促进残疾人健康的关键问题。我们目前的研究使用个性化的干预方法与电话辅导支持，以实现增加身体活动的参与，降低身体质量指数（BMI），并减少医疗保健的利用。拟议的项目将通过以下方式扩大这一有前途的研究的范围：（1）在实施干预措施方面培训多名健康教练;（2）使用计算机辅助系统进行基线评估，促进目标制定，确定当地资源，并监测进展情况;（3）增加营养成分，以检查对健康结果的累加效应;以及（4）从多个地点招募更多样化的行动不便者样本。将228名患有行动障碍（脊髓损伤、多发性硬化症、脑瘫、脊柱裂）的肥胖个体随机分为以下三种情况之一：（1）PEP-II，仅涉及身体活动电话辅导的个性化身体活动计划;（2）PEP Plus，个性化身体活动和营养辅导;以及（3）对照组。合格标准包括（a）医生允许参与研究;（B）BMI为30-40;（c）能够用英语匡威;（d）未参加另一健康促进计划;和（e）在过去六个月内久坐不动的生活方式。主要结果包括体力活动，营养，自我效能，血压，血脂和医疗保健利用成本。干预组参与者将在以下阶段接受健康电话辅导：（a）0-6个月（采用）-每周辅导;（B）7-12个月（维持）-每两个月到每月辅导;（c）12-18个月（随访）-无辅导。我们假设，相对于对照组，干预组将在身体活动，营养摄入和自我效能的测量方面取得显着进步，以及医疗保健利用，体重指数，血压和血脂的显着降低。在这些相同的结果指标上，假设PEP Plus组的参与者相对于PEP-II组的参与者有显著的收益。将使用一系列混合模型进行意向治疗分析，这些模型将随时间推移比较三个治疗组（试验前和试验后6个月、12个月和18个月）。

DESCRIPTION (provided by applicant): Developing effective and sustainable interventions to increase key health behaviors remains a critical issue in health promotion for people with disabilities. Our current research uses a personalized intervention approach with telephone coaching support to achieve increases in physical activity participation, lowering of body mass index (BMI), and reduced healthcare utilization. The proposed project will expand the scope of this promising research by (1) training multiple wellness coaches in the implementation of the intervention; (2) using a computer-assisted system to conduct baseline assessment, facilitate goal development, identify local resources, and monitor progress; (3) adding a nutrition component to examine the additive effects on health outcomes; and (4) recruiting a more diverse sample of persons with mobility disabilities from multiple sites. 228 obese individuals with mobility disabilities (spinal cord injury, multiple sclerosis, cerebral palsy, spina bifida) will be randomized into one of three conditions: (1) PEP-II, Personalized Physical Activity Program involving physical activity telephone coaching only; (2) PEP Plus, Personalized Physical Activity and Nutrition coaching; and (3) control group. Eligibility criteria include (a) permission from physician to participate in the study; (b) BMI of 30-40; (c) have the ability to converse in English; (d) not enrolled in another health promotion program; and (e) sedentary lifestyle over the previous six months. Primary outcomes include physical activity, nutrition, self-efficacy, blood pressure, blood lipids, and healthcare utilization costs. Intervention group participants will receive wellness telephone coaching in the following phases: (a) 0-6 months (Adoption) - weekly coaching; (b) 7-12 months (Maintenance) - bimonthly to monthly coaching; (c) 12-18 months (Follow up) - no coaching. We hypothesize that relative to controls, the intervention groups will evidence significant gains on measures of physical activity, nutrition intake, and self- efficacy, as well as significant reduction in healthcare utilization, BMI, blood pressure and blood lipids. On these same outcome measures, participants in the PEP Plus group are hypothesized to evidence significant gains relative to their PEP-II counterparts. Intention-to-treat analysis will be conducted using a series of mixed models that will compare the three treatment groups over time (pre-test and six, 12 and 18-month post-test).