COVID Extension: Mobile Health Obesity Wellness Intervention in Rural Adults

项目概要： 肥胖症的全国流行也影响到老年人，并与增加的风险有关。 功能障碍、疗养院安置和早期死亡率。传统的减肥计划有 减少身体脂肪的潜力，但由于交通和 流动性挑战。它们还可能导致肌肉和骨骼的有害损失，矛盾地导致 增加残疾。这个指导职业发展奖的首要目标是发展技能， 成为一个独立的研究员，在社区为基础的转化老年肥胖症研究， 创新技术，包括移动的健康（mHealth）、传感器和具有行为的视频会议 管理，以改善身体功能。我将建立在我以前的工作中获得的知识， 描述性研究，以获得必要的技能和知识，在这个5年的奖项，成为一个 老年肥胖干预研究的独立R 01研究者。辅导活动、培训和 在关键内容领域的课程将包括：临床试验方法（定性和定量）;交付 在农村人口中使用应用远程医疗方法进行基于社区的肥胖干预; 使用移动健康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。 与此同时，我将进行一项旨在开发和评估一项技术的试点研究计划， 为肥胖的老年人提供辅助健康干预。首先，我建议评估可接受性，可用性， 使用一种新颖的、适应性强的移动健康技术， 具有遥感和自我监测功能的设备（Amulet），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，我将进行一个单臂， 试点可行性研究，评估mHealth肥胖健康干预（MOWI）的潜在有效性 对于老年肥胖成年人在改善身体功能（发展和完善MOWI）。MOWI将Amulet与 每周一次由营养师指导的营养课程，沿着每周两次由理疗师指导的小组 练习会话。我将在3个月的时间内在基于研究的环境中对MOWI进行试点测试，然后交付 在6个月的时间内使用视频会议在家庭环境中进行干预（评估家庭MOWI）。的 主要临床结果是身体功能，通过观察到的肌肉力量、观察到的身体功能、 健身，以及观察和自我报告的生活任务功能。次要（探索性）结局将包括 行为激活、客观身体活动、主观健康状况和主观身体活动。的 关于可行性、可接受性和初步估计有效性的调查结果将在未来使用 竞争性应用程序的校外R 01评估家庭远程医疗提供的有效性， MOWI在改善高风险肥胖老年人的身体功能方面与亲自干预相比。

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.