Testing the Efficacy of a Technology-Assisted Weight Management Intervention within Patient-Centered Medical Homes: The GEM (Goals for Eating and Moving) Study

测试以患者为中心的医疗之家中技术辅助体重管理干预措施的功效：GEM（饮食和运动目标）研究

• 批准号: 10000126
• 负责人: Melanie Jay
• 金额: $ 66.21万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-20 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10000126
• 关键词: Address; Adopted; Adoption; Adult; Advisory Committees; Appointment; Attitude; Body Weight Changes; Body Weight decreased; Body mass index; Caring; Clinical; Competence; Computer software; Control Groups; Counseling; Data; Eating; Educational Materials; Enrollment; Evaluation; Future; Glycosylated hemoglobin A; Goals; Health; Health Promotion; Health system; Healthcare Systems; Home environment; Hyperlipidemia; Hypertension; Individual; Intake; Intervention; Licensing; Life Style; Lipids; Maintenance; Medical; Medical Care Team; Medical center; Medicare; Modeling; Monitor; Motivation; New York; Obesity; Outcome; Patient Education; Patient-Centered Care; Patients; Physical activity; Preventive service; Primary Health Care; Process; Provider; Randomized; Randomized Controlled Trials; Self Efficacy; Services; Site; Structure; Tablet Computer; Technology; Telephone; Testing; Time; Transportation; United States; Urban Health; Veterans; Visit; Weight; Weight maintenance regimen; Work; arm; base; behavior change; behavioral outcome; blood pressure reduction; cardiometabolic risk; care providers; comorbidity; comparison intervention; design; diabetes prevention program; diabetes risk; disorder prevention; effectiveness testing; efficacy testing; evidence base; follow-up; fruits and vegetables; group intervention; improved; innovative technologies; intervention program; lifestyle intervention; novel; obesity treatment; patient oriented; patient population; patient-level barriers; population health; primary care setting; primary outcome; programs; randomized trial; recruit; therapy design; tool; treatment arm; treatment as usual; usual care arm; waist circumference

PROJECT SUMMARY The United States Preventive Services Task Force (USPSTF) recommends that primary care providers use the 5As framework (Assess, Advise, Agree, Assist, Arrange) to provide counseling to obese patients. Providers frequently do not counsel patients due to barriers such as competing demands and low perceived competency which may contribute to poor patient attendance to effective weight management programs. Patient-centered medical homes can use team-based care to address these barriers, increase attendance to intensive weight management programs, and provide weight management services to those who do not to attend. We developed and formatively evaluated an innovative, technology-assisted 5As-based intervention to promote weight loss, behavior change, and increase enrollment in intensive programs (e.g. the MOVE! program from the Veteran’s Affairs (VA) and the Diabetes Prevention Program) within medical homes. This intervention, called GEM (Goals for Eating and Moving), uses 4 components to deliver 5As counseling—the GEM online tool, health coach counseling, brief primary care team counseling, and follow-up telephone coaching. The GEM tool is a mobile-friendly software program delivered via tablet computers in the primary care setting to facilitate counseling by a health coach and primary care staff. Our preliminary data suggest that the GEM intervention is feasible and acceptable to patients and staff and facilitates 5As counseling. A randomized trial is needed to examine its impact on weight loss and health outcomes. We will conduct a cluster-randomized controlled trial at 2 urban health centers: the VA New York Harbor and at sites within the Montefiore Medical Group (MMG) to assess the efficacy of the GEM intervention compared to Enhanced Usual Care. We will recruit 512 patients from 16 primary care teams (8 from VA sites, 8 from MMG sites), each with 2 or more primary care providers. Eligible patients with a Body Mass Index of ≥30 kg/m2 or >25 kg/m2 and comorbidities with upcoming primary care appointments will be recruited via mail with follow up telephone calls. Patients within primary care teams randomized to the intervention group will receive the GEM intervention and those in the control group will receive Enhanced Usual Care. The primary outcome will be weight loss at the end of the 1 year intervention. We will use the RE-AIM evaluation framework to assess the reach (proportion of eligible patients who enroll), efficacy (weight loss and other related outcomes), adoption (acceptability to primary care teams), implementation (intervention fidelity) and maintenance (sustainability of weight change and program components between 12 and 24 months post-randomization).

项目总结

项目成果

Procedural Fairness in Physician-Patient Communication: A Predictor of Health Outcomes in a Cohort of Adults with Overweight or Obesity.

医患沟通中的程序公平性：超重或肥胖成年人群体健康结果的预测因素。

• DOI: 10.1007/s12529-024-10282-6
• 发表时间: 2024
• 期刊: International journal of behavioral medicine
• 影响因子: 2.7
• 作者: Wittleder,Sandra;Viglione,Clare;Reinelt,Tilman;Dixon,Alia;Jagmohan,Zufarna;Orstad,StephanieL;Beasley,JeannetteM;Wang,Binhuan;Wylie-Rosett,Judith;Jay,Melanie
• 通讯作者: Jay,Melanie