Innovative Technology to Improve Patient Adherence to Weight Loss Recommendations

提高患者对减肥建议的依从性的创新技术

• 批准号: 7821734
• 负责人: Rena R Wing
• 金额: $ 48.59万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7821734
• 关键词: Accountability; Address; Adherence; Affect; American; Applications Grants; Area; Behavioral; Body Weight; Body Weight decreased; Characteristics; Clinical; Computers; Control Groups; Counseling; Data; Diet; Education; Educational process of instructing; Elements; Feedback; Goals; Health; Health Benefit; Health behavior; Individual; Internet; Link; Maintenance; Measures; Medical; Modeling; Monitor; Morbidity - disease rate; Obesity; Online Systems; Outcome; Overweight; Participant; Patient Self-Report; Patients; Performance; Physical activity; Physicians; Play; Public Health; Published Comment; Randomized; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Recommendation; Records; Reporting; Research; Resources; Role; Suggestion; System; Technology; Testing; Time; Training; Treatment Protocols; Visit; Weight; Weight maintenance regimen; Writing; base; behavior change; compliance behavior; computer generated; cost; design; experience; follow-up; improved; innovation; innovative technologies; mortality; new technology; programs; skills; web site

DESCRIPTION (provided by applicant): This application addresses broad Challenge Area (06)-Enabling Technologies and Specific Challenge Topic 06-OD(OBSSR)-101* Using new technologies to improve or measure adherence. Overweight/obesity is a major health problem that affects over two-thirds of Americans, increases morbidity and mortality and has annual medical costs exceeding $75 billion. Although many Americans indicate that they are trying to lose weight, adherence to weight loss regimens is often poor. Programs are needed that can improve adherence and weight loss for overweight/obese individuals. Physicians play an important role in motivating patients to improve health behaviors and recent reviews suggest that having physicians advise patients to lose weight and then referring patients to an effective program produces the best behavior change and maintenance. The problem, however, is that physicians currently have limited options for such referrals. The challenge for the field is to develop a program to which physicians can refer their overweight/obese patients. The program must be low cost, easily accessible, and must promote adherence to the weight loss regimen and consequently improve weight loss outcomes. The goal of this Challenge Grant application is to develop and test an innovative web-based program that would provide an accessible and effective approach to enhancing adherence to clinical recommendations for weight loss. If effective, the program would provide an outstanding resource for physicians and their patients and could consequently have important clinical and public health impact. We propose to develop a program based on our prior research that uses innovative Internet technology to provide a low cost, easily disseminated program that captures two critical elements of effective behavioral weight loss programs-namely, training in key behavioral weight control strategies and increased participant accountability. Patients, referred by their physician for weight loss, will be offered a 12 week program that they can view at their convenience on their computer. The program will use Web-based interactive multi-media approaches for presentation of the behavioral skills and provide a Web-based form for submission of self- monitoring and weight data; to maximize patient accountability, the program will include a system of automated feedback for participants, which comments on their weight loss to date and their performance within several behavioral weight-loss domains, with suggestions tailored to the characteristics and performance of the individual. Periodic reports on the patients' progress will also be sent to the referring physician. We will test this program in a randomized trial with 250 patients referred by their physicians who will be randomly assigned to either Internet Education (Control) (N=125) or to the Innovative Technology program (N=125). Participants in both groups will receive a 12 week Internet program of either basic weight loss education or the Innovative Technology program and will be weighed at the start and end of the 3 month program and at 3 month follow- up. The primary hypothesis is that patients who are assigned to the Innovative Technology program will achieve larger average weight losses than those in the control group over the 12-week program. Secondary hypotheses are that the Innovative technology group will adhere better over the 12-weeks (assessed by log-ins to the web site and self-reported changes in diet and activity) and achieve better weight losses at 6 months than the control group. The proposed project addresses the significant problem of obesity and uses innovative technology to improve adherence to a behavioral weight loss strategies. If the program is effective, it would provide an outstanding resource for physicians to use with their patients and thus would have tremendous clinical impact. The proposed project addresses the significant problem of obesity and uses innovative technology to improve adherence to a behavioral weight loss strategies. If the program is effective, it would provide an outstanding resource for physicians to use with their patients and thus would have tremendous clinical impact.

描述（由申请人提供）：本申请解决了广泛的挑战领域（06）-使能技术和特定挑战主题06-OD（OBSSR）-101* 使用新技术来改善或衡量依从性。超重/肥胖是影响超过三分之二的美国人的主要健康问题，增加了发病率和死亡率，并且每年的医疗费用超过750亿美元。尽管许多美国人表示他们正在努力减肥，但坚持减肥方案的情况往往很差。需要可以改善超重/肥胖个体的依从性和减肥的计划。医生在激励患者改善健康行为方面发挥着重要作用，最近的评论表明，让医生建议患者减肥，然后将患者转诊到有效的计划中，可以产生最佳的行为改变和维持。然而，问题是，医生目前对这种转诊的选择有限。该领域的挑战是开发一个程序，医生可以将他们的超重/肥胖患者转诊到该程序。该计划必须是低成本的，容易获得的，必须促进遵守减肥方案，从而改善减肥结果。这个挑战补助金申请的目标是开发和测试一个创新的基于网络的程序，将提供一个可访问的和有效的方法，以提高遵守临床建议减肥。如果有效，该计划将为医生及其患者提供出色的资源，并可能因此产生重要的临床和公共卫生影响。我们建议开发一个程序的基础上，我们以前的研究，使用创新的互联网技术，提供一个低成本，易于传播的程序，捕获两个关键要素的有效行为减肥计划，即，培训的关键行为体重控制策略和增加参与者的责任。患者，由他们的医生介绍减肥，将提供一个12周的计划，他们可以在他们方便的电脑上查看。该计划将使用基于网络的互动多媒体方法来介绍行为技能，并提供基于网络的表格来提交自我监测和体重数据;为了最大限度地提高患者的责任感，该计划将包括一个自动反馈系统，供参与者评论他们迄今为止的减肥情况以及他们在几个行为减肥领域的表现，并根据个人的特点和表现提出建议。关于病人进展的定期报告也将发送给转诊医生。我们将在一项随机试验中对该计划进行测试，其中250名患者由他们的医生转诊，他们将被随机分配到互联网教育（对照）（N=125）或创新技术计划（N=125）。两组的参与者将接受为期12周的互联网计划，包括基础减肥教育或创新技术计划，并将在3个月计划的开始和结束以及3个月随访时称重。主要假设是，在12周的计划中，被分配到创新技术计划的患者将比对照组实现更大的平均体重减轻。次要假设是，创新技术组在12周内将更好地坚持（通过登录网站和自我报告的饮食和活动变化进行评估），并在6个月时实现比对照组更好的体重减轻。拟议的项目解决了肥胖的重大问题，并使用创新技术来提高对行为减肥策略的坚持。如果该计划是有效的，它将提供一个优秀的资源，医生使用与他们的病人，从而将有巨大的临床影响。拟议的项目解决了肥胖的重大问题，并使用创新技术来提高对行为减肥策略的坚持。如果该计划是有效的，它将提供一个优秀的资源，医生使用与他们的病人，从而将有巨大的临床影响。