Evaluation of Low Cost National Weight Loss Program in the Underserved

描述(由申请人提供)：这是Nia S.Mitchell，医学博士，公共卫生硕士Nia S.Mitchell首次提交NHLBI K01促进生物医学研究中教师多样性的导师职业发展奖(RFA-HL-12-030)。米切尔博士的主要职业目标是成为开发和实施针对服务不足人群的减肥计划的领导者。她的研究提案使用明智地减轻体重(TOPS)作为一个模型，以产生新的证据，证明为服务不足的人群提供服务的基于社区的计划的有效性。候选人：米切尔博士是科罗拉多大学安舒茨医学院普通内科的董事会认证内科医生和医学助理教授。她完成了公共卫生硕士学位，并对减肥计划进行了三次数据库分析，其中一项是针对田纳西州医疗补助接受者的TOPS计划和两项慧俪轻体计划。她与她的主要导师詹姆斯·O·希尔博士密切合作，两人在媒体上发表了一篇文章，目前正在审查两篇文章。培训：拟议的K01职业发展计划建立在团契和早期职业发展的先前经验基础上，侧重于需要额外培训的三个领域：1)获得地理信息系统(GIS)技能；2)提高生物统计、计算机建模和分组分析技能；3)提高定性研究方法的技能。因此，米切尔博士建议通过拟议的研究进行密集的专题指导、重点课程作业、研讨会和情景学习。这些培训活动将使米切尔博士能够学习如何严格评估为服务不足的人群提供服务的社区项目。导师/环境：米切尔博士和她的主要导师希尔博士组建了一个强大的导师团队，他们将指导米切尔博士完成拟议的培训和研究活动。此外，米切尔博士是科罗拉多州健康与健康中心唯一一名代表性不足的少数族裔研究员，也是唯一一名研究针对服务不足人群的体重管理干预措施的研究员，这使她成为健康与健康中心的宝贵财富。研究：迫切需要挑战目前体重管理计划的模式，这种模式在负担能力、减肥维持和实施方面存在问题，特别是在低收入和少数族裔人群中。这项研究将产生与那些在临床实践中工作的人直接相关的信息。目标1将确定TOPS计划在包括低收入和少数民族人口在内的服务不足地区的覆盖范围，这对于了解这些人口获得该计划的程度至关重要。这一目的还将有助于对章节进行分类，以进行分组分析，以确定与各章节之间的不同效力相关的特征。目标2将建立在米切尔博士先前研究的基础上，以确定TOPS计划的六年有效性以及各章节之间的不同有效性，这将使米切尔博士能够根据表现对章节进行排名，以便将它们划分为五等分，并在目标3中进行定量研究。目标3将提供对TOPS计划实施情况的清晰概念性理解，因为它发现了影响绩效的章节特征，以及如何修改这些属性，以将服务于低收入人群的章节的绩效提高到最高水平。摘要：该项目在几个方面具有创新性。也许最重要的方式是，它提供了体重管理的范式转变，通过应用科学的严谨性来利用 全国性非营利组织的基础设施。它没有设计一个新的减肥计划，而是用最少的基础设施来广泛传播和实施，而是严格地研究一个已经在全国数千个社区存在的计划。该项目将有助于更好地了解TOPS计划的有效性，特别是在服务不足的人群中，并使米切尔博士能够最大限度地在这些人群中实施该计划。实施这项有指导的研究和培训计划--评估低服务人群的低成本国家减肥计划--将有助于米切尔博士发展成为全国公认的独立调查者和领导者，进行从根本上改变和改善低收入和少数族裔人群体重管理的研究。(摘要结束)

DESCRIPTION (provided by applicant): This is a first submission for an NHLBI K01 Mentored Career Development Award to Promote Faculty Diversity in Biomedical Research (RFA-HL-12-030) by Nia S. Mitchell, MD, MPH. Dr. Mitchell's overarching career goal is to be a leader in the development and implementation of weight loss programs to underserved populations. Her research proposal uses Take Off Pounds Sensibly (TOPS) as a model for generating new evidence of the effectiveness of community-based programs that provide services to underserved populations. Candidate: Dr. Mitchell is a board-certified internist and an Assistant Professor of Medicine in the Division of General Internal Medicine at the University of Colorado Anschutz Medical Campus. She has completed a Master of Public Health degree and has conducted three database analyses of weight loss programs one of the TOPS program and two of the Weight Watchers program for Tennessee Medicaid recipients. She works closely with her primary mentor, James O. Hill, PhD, with whom she has one article in press and two currently under review. Training: The proposed K01 career development plan builds on prior experience from fellowship and early career development to focus on three areas that require additional training: 1) acquiring skills in geographic information systems (GIS); 2) improving skills in biostatistics, computer modeling, and subgroup analyses; and 3) improving skills in qualitative research methods. Accordingly, Dr. Mitchell proposes intensive topical mentorship, focused coursework, seminars, and contextual learning through the proposed research. These training activities will enable Dr. Mitchell to learn how to rigorously evaluate community-based programs that provide services to underserved populations. Mentors/Environment: Dr. Mitchell and her primary mentor, Dr. Hill, have assembled a strong mentorship team who will guide Dr. Mitchell through the proposed training and research activities. Additionally, Dr. Mitchell is the only underrepresented ethnic minority researcher at the Colorado Health and Wellness Center and she is the only researcher studying weight management interventions for underserved populations, which makes her a valuable asset to the Health and Wellness Center. Research: There is a pressing need to challenge the current paradigm of weight management programs, which has problems with affordability, weight loss maintenance, and implementation especially in low income and minority populations. This study will produce information of direct relevance to those working in clinical practice. Aim 1 will determine the reach of the TOPS program into underserved areas including those with low income and ethnic minority populations, which is essential to understanding the degree to which these populations are accessing the program. This aim will also help categorize chapters for subgroup analyses to determine the features that are associated with the variable effectiveness among chapters. Aim 2 will build upon Dr. Mitchell's prior research to determine the six-year effectiveness of the TOPS program as well as the differential effectiveness among chapters, which will allow Dr. Mitchell to rank chapters based on performance so they can be divided into quintiles and studied quantitatively in Aim 3. Aim 3 will provide a clear conceptual understanding of the implementation of the TOPS program as it discovers the chapter characteristics that influence performance and how these attributes might be modified to raise performance of chapters that serve low income populations to the highest levels. Summary: This project is innovative in several ways. Perhaps the most important way is that it offers a paradigm shift in weight management by applying scientific rigor to utilize the infrastructure of a national nonprofit organization. Instead of designing a new weight loss program with minimal infrastructure for wide- spread dissemination and implementation, it rigorously studies a program that is already present in thousands of communities across the country. This project will allow for a better understanding of the effectiveness of the TOPS program, especially in underserved populations, and allow Dr. Mitchell to maximize future implementation of the program in these populations. Conduct of this mentored research and training proposal, Evaluation of a Low Cost National Weight Loss Program in the Underserved, will facilitate Dr. Mitchell's development into a nationally-recognized independent investigator and leader conducting research that fundamentally changes and improves weight management in low income and minority populations. (End of Abstract)