Novel and Scalable Internet Supplemented Weight Loss Treatment in Primary Care.

初级保健中新颖且可扩展的互联网补充减肥治疗。

• 批准号: 8966768
• 负责人: RACHEL D BARNES
• 金额: $ 8.33万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8966768
• 关键词: Address; Adherence; Aftercare; American; Appointment; Binge eating disorder; Body Weight decreased; Body mass index; Characteristics; Client satisfaction; Clinical; Cognitive; Combined Modality Therapy; Data; Diet; Eating Disorders; Elements; Enrollment; Ensure; Funding; Health Personnel; Heart Diseases; Individual; Internet; Intervention; Intervention Studies; Lead; Life; Literature; Manuscripts; Medical; Mental Depression; Mentors; Metabolic; Metabolic syndrome; Methods; Monitor; Moods; Motivation; Obesity; Outcome; Overweight; Participant; Patients; Primary Health Care; Provider; Public Health; Race; Randomized; Randomized Controlled Trials; Recommendation; Recruitment Activity; Relative (related person); Research; Research Personnel; Resources; Self Determination; Staging; Stroke; Structure; Symptoms; Testing; Time; Training; Treatment outcome; Triglycerides; Weight; Withholding Treatment; base; behavior change; career; comparison group; cost; design; experience; follow-up; improved; individualized feedback; innovation; interdisciplinary treatment approach; intervention effect; meetings; metabolic depression; motivational enhancement therapy; novel; nutrition; programs; psychoeducation; psychologic; public health relevance; sex; success; theories; tool; treatment adherence; treatment as usual; treatment duration; weight loss intervention

 DESCRIPTION (provided by applicant): Overweight and obesity are costly and prevalent public health problems facing the majority of Americans. Being overweight or obese is related to heart disease, stroke, metabolic syndrome, and other deadly consequences. Barriers to receiving traditional weight loss treatment with a therapist include cost, time, and accessibility.A place to intervene may be at individuals' primary care provider appointments. Unfortunately, most primary care providers are busy and may not have the time or resources to provide treatment. Therefore, it is important to design and test effective weight loss treatments that do not require extensive training or time. As such, the internet has extensive public health potential for widespread dissemination of behavior change tools and interventions for weight loss. Internet-based treatment outcomes can be further improved by incorporating clinician support for weight loss, the use of online programs, and individualized feedback. The purpose of this application is to address overweight and obesity by testing an easily accessible weight loss treatment that can be provided in primary care centers (PCCs). The first aim includes a treatment approach that combines two recently developed weight loss treatments that received initial empirical support relative to Usual Care (UC) in a K23-funded randomized controlled trial (RCT). In the proposed study, patients will receive both Nutrition Psychoeducation (NPC) and Motivational Interviewing (MIC), supplemented by the internet for 12 weeks, to determine outcomes associated with this conceptually synergistic combination (NPC+MIC). Treatment will be provided by medical assistants; this method of delivery is intended to increase generalizability to other PCCs. Patients will be comprehensively assessed at baseline, post treatment, and at 3-month follow-up. It will be important to test MIC and NPC combined, as NPC+MIC may lead to even more weight and weight-related changes. The feasibility, however, of combining these treatments requires empirical examination. The study will provide needed empirical information about a scalable and potentially effective weight loss option for primary care offices. Patients receiving NPC+MIC are hypothesized to experience significant weight loss and improvements in metabolic variables and mood. The second aim is to compare the NPC+MIC outcomes to those from the completed K23 RCT study that compared UC to two internet supplemented treatments, NPC or MIC alone, provided in primary care by medical assistants. The current application addresses limits of the treatment literature by including free and easily accessible internet support, patients who are overweight and obese, metabolic syndrome, patients with binge eating disorder, treatment clinicians available to many PCCs, assessment of treatment fidelity, and follow-up assessment after a period of treatment cessation. The outcomes for patients receiving NPC+MIC are hypothesized to be significantly better than for those who received NPC alone, MIC alone, or UC in the K23 RCT.

 描述（由申请人提供）：超重和肥胖是大多数美国人面临的昂贵和普遍的公共卫生问题。超重或肥胖与心脏病、中风、代谢综合征和其他致命后果有关。接受传统减肥治疗的障碍包括费用、时间和可及性。干预的地方可能是个人的初级保健提供者预约。不幸的是，大多数初级保健提供者都很忙碌，可能没有时间或资源来提供治疗。因此，设计和测试不需要大量训练或时间的有效减肥治疗是很重要的。因此，互联网具有广泛的公共卫生潜力 广泛传播行为改变工具和减肥干预措施。基于互联网的治疗结果可以通过结合临床医生对减肥的支持，在线程序的使用和个性化反馈来进一步改善。本申请的目的是通过测试可在初级保健中心（PCC）提供的易于获得的减肥治疗来解决超重和肥胖问题。第一个目标包括一种治疗方法，该方法结合了两种最近开发的减肥治疗方法，这些治疗方法在K23资助的随机对照试验（RCT）中获得了相对于糖尿病护理（UC）的初步经验支持。在拟议的研究中，患者将接受营养心理教育（NPC）和动机访谈（MIC），并辅以互联网，为期12周，以确定与这种概念上的协同组合（NPC+MIC）相关的结果。治疗将由医务助理提供;这种提供方法旨在提高对其他PCC的普遍性。将在基线、治疗后和3个月随访时对患者进行全面评估。重要的是要测试MIC和NPC的组合，因为NPC+MIC可能会导致更多的体重和体重相关的变化。然而，结合这些治疗的可行性需要实证检验。这项研究将为初级保健办公室提供有关可扩展和潜在有效的减肥选择所需的经验信息。假设接受NPC+MIC的患者经历显著的体重减轻和代谢变量和情绪的改善。第二个目的是将NPC+MIC结局与已完成的K23 RCT研究的结局进行比较，该研究将UC与两种互联网补充治疗（NPC或MIC单独治疗）进行了比较，这些治疗由医疗助理在初级保健中提供。本申请通过纳入免费且易于访问的互联网支持、超重和肥胖患者、代谢综合征患者、暴食症患者、许多PCC可用的治疗临床医生、治疗保真度评估以及治疗停止一段时间后的随访评估来解决治疗文献的局限性。在K23 RCT中，假设接受NPC+MIC治疗的患者的结局显著优于接受单独NPC、单独MIC或UC治疗的患者。