Digital Health Supported Weight Management Intervention Delivered by Community Health Workers among Public Housing Residents

数字健康支持社区卫生工作者对公共住房居民进行的体重管理干预

• 批准号: 10577816
• 负责人: Lisa M. Quintiliani
• 金额: $ 17.94万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-14 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10577816
• 关键词: Adoption; Behavior; Behavioral; Body Weight decreased; Boston; Cellular Phone; Cessation of life; Characteristics; Chronic Disease; Cluster randomized trial; Communities; Community Health Aides; Control Groups; Cost Effectiveness Analysis; Counseling; Coupled; Development; Devices; Diet; Diet Monitoring; Disease; Disparity; Education; Educational Materials; Environment; Ethnic Origin; Face; Feedback; Health; Health Priorities; Health Promotion; Health behavior change; High Prevalence; Housing; Incidence; Income; Institute of Medicine (U.S.); Intervention; Link; Low Income Population; Low income; Malignant Neoplasms; Measures; Mediating; Mental Depression; Minority Groups; Modeling; Monitor; Motivation; Obesity; Obesity associated cancer; Outcome; Overweight; Ownership; Participant; Persons; Physical activity; Pilot Projects; Policies; Population; Positioning Attribute; Public Housing; Quality-Adjusted Life Years; Race; Reporting; Research; Resources; Risk Behaviors; Role; Self Efficacy; Social Environment; Social support; Technology; Testing; Text Messaging; Treatment Efficacy; Weight; Weight maintenance regimen; behavior change; cancer risk; care delivery; comorbidity; comparison intervention; cost; design; digital; digital health; digital technology; eHealth; effective therapy; efficacy evaluation; ethnic minority; ethnic minority population; evidence base; expectation; fruits and vegetables; health disparity; implementation fidelity; improved; incremental cost-effectiveness; insight; intervention effect; knowledge base; low socioeconomic status; mHealth; mortality; motivational enhancement therapy; nutrition; programs; racial minority; racial minority population; research study; secondary outcome; social; social cognitive theory; sociodemographics; sugar; sweetened beverage; telephone based; telephone coaching; tool; web site

PROJECT SUMMARY Overweight/obesity is strongly linked to mortality from multiple chronic diseases, including obesity-related cancers. For health disparity-facing populations, including racial/ethnic minority and/or low income individuals, who have both high prevalence of obesity and cancer, interventions promoting behavioral change for nutrition, physical activity, and weight are a national health priority. A growing knowledge base documents the efficacy of community health worker supported interventions for improving behavioral change due, at least in part, to their unique insights into how an intervention should be adapted to social and environmental contexts. While there has been a rapid expansion in the use of digital technologies for delivering health interventions, there has been little study of the potential use of these technologies in the U.S. by non-professional health workers, including community health workers. Yet, it is not yet clear if digital technologies alone are efficacious for weight loss, particularly among health disparity-facing populations, or if a more intense intervention consisting of a combination of community health workers plus digital technologies will be needed to successfully promote weight loss among health disparity-facing populations. In the proposed research study, we will target weight management among obese residents of Boston's public housing developments who are low-income and predominately from racial/ethnic minority groups. This R01 proposal seeks to examine the efficacy of an intervention approach that combines mHealth technology plus website-driven behavioral counseling from community health workers. Our hypothesis is that in a 12-month cluster-randomized trial (n=504) comparing 3 public housing developments (n=168 participants) who receive community health worker motivational interviewing behavioral counseling plus mHealth self-monitoring/text message feedback (mHealth+CHW), versus 3 developments (n=168) who receive the mHealth self-monitoring/text message feedback only (mHealth only), versus 3 developments (n=168) who receive assessment only (control group), both mHealth+CHW and mHealth only will outperform assessment only control and mHealth+CHW will outperform mHealth only in terms of weight loss at 12 months. For secondary outcomes, we will examine intervention effects on diet and physical activity behaviors. We will also examine mediating effects of Social Cognitive Theory constructs and moderating effects of participant characteristics and social contextual variables on the effect of the intervention. Finally, we will conduct a cost-effectiveness analysis. Our results will enable a better understanding of efficacious approaches to weight management among health disparity-facing populations, which may be applied to other modifiable cancer risk behaviors and be extended into the larger federal network of public housing administrations.

项目摘要 超重/肥胖与多种慢性疾病的死亡率密切相关，包括与肥胖有关 癌症。对于面向健康差异的人群，包括种族/族裔少数民族和/或低收入人群， 肥胖和癌症患病率很高，干预措施促进营养行为改变， 体育锻炼和体重是国家健康的重点。不断增长的知识基础记录了 社区卫生工作者支持改善行为改变的干预措施，至少部分是由于他们的 关于如何适应社会和环境环境的独特见解。那里 在使用数字技术提供健康干预措施方面，已经很快扩展了 非专业卫生工作者包括 社区卫生工作者。但是，尚不清楚仅凭数字技术是否有效减肥， 特别是在面向健康差异的人群中 社区卫生工作者以及数字技术的结合将成功促进 面向健康差异的人群的体重减轻。在拟议的研究中，我们将针对体重 波士顿公共住房开发项目的肥胖居民的管理 主要来自种族/族裔少数群体。该R01提案旨在研究 结合MHealth技术以及网站驱动的行为咨询的干预方法 社区卫生工作者。我们的假设是，在一个12个月的聚类随机试验（n = 504）中，比较了3 公共住房发展（n = 168名参与者），他们获得社区卫生工作者的励志 采访行为咨询加MHealth自我监控/短信反馈（MHealth+CHW）， 仅接收MHealth自我监控/短信反馈的3个发展（n = 168） （仅MHealth），与仅接受评估的3个发展（n = 168），两者都 MHealth+CHW和MHealth只能胜过控制权，而MHealth+CHW的表现将超越 仅在12个月时减肥方面。对于次要结果，我们将检查干预 对饮食和体育锻炼行为的影响。我们还将研究社会认知的中介作用 理论构建和参与特征和社会背景变量对 干预的影响。最后，我们将进行成本效益分析。我们的结果将使更好 了解面向健康差异的人群之间的体重管理方法的有效方法， 可以应用于其他可修改的癌症风险行为，并扩展到更大的联邦网络 公共住房管理部门。