Development of a Functional Health CAT for Managing Obesity

描述(申请人提供)：用于管理肥胖的功能性健康猫的开发摘要近几十年来，肥胖症在美国的流行程度急剧上升，给个人和社会造成了巨大的负担。虽然行为因素是导致肥胖的最主要原因之一，目前也提供了许多体重管理计划，但目前几乎没有实用的工具来衡量肥胖成年人的功能健康和其他特征，这些特征决定和定义了体重管理计划的成功。我们建议使用项目反应理论(IRT)和计算机化自适应测试(CAT)技术来构建准确而简短的患者报告结果(PRO)工具(肥胖-CAT)来测量肥胖对健康相关生活质量(HRQOL)和自我效能预期的影响。CATS为每个被调查者量身定制问题，从而在不增加被调查者负担的情况下提高了测量的精度和范围。在第一阶段，我们建议：(1)建立两个题库来测量肥胖对HRQOL的影响和控制体重的自我效能期望；(2)开发一个全面和灵活的肥胖CAT软件解决方案，包括即时反馈报告；(3)与传统的全长静态问卷相比较，对新工具进行初步测试。为了实现这些目标，我们与麦哲伦健康服务公司合作，麦哲伦健康服务公司是美国最大的管理保健组织之一，为4000万人提供服务。我们将共同开发专门为CAT流程量身定做的肥胖特定项目，分析1,000名员工(约75%超重或肥胖)样本中的项目参数，最后在100名参与者中测试肥胖CAT纳入麦哲伦全国体重管理计划的可行性和接受度。第一阶段的产品将是一个原型的全面肥胖猫，具有关于可行性、可接受性和经验表现的初步证据。在第二阶段，将改进和进一步评估该工具的有效性、可靠性和响应性，以及它在预测和监测治疗成功方面的潜力，并将对该工具进行评估和编程，使其能够在不同的平台上充分运作，包括PDA和交互式语音识别(IVR)。通过大幅降低数据收集成本，减轻反应负担，消除“天花板”和“地板”效应，提高个体评分的精确度，HRQOL常规监测可能成为成年人肥胖的一种临床工具。肥胖猫将能够监测体重管理计划的成功，以提高超重和肥胖成年人与健康相关的生活质量。此外，它还将支持为个人量身定做体重管理计划，并确定哪些人退出该计划的风险较高，需要特别关注。与现有仪器相比，它将大大降低数据收集成本，减轻反应负担，并提高个体评分的精确度，从而使HRQOL常规监测成为成年人肥胖的临床工具可能成为可行的。

DESCRIPTION (provided by applicant): Development of a Functional Health CAT for Managing Obesity Abstract In recent decades the prevalence of obesity has increased dramatically in the United States, causing a great burden for the individual and society. Although behavioral factors are among the most prominent causes of obesity and numerous weight management programs are currently offered, few practical instruments are available today to measure the functional health and other characteristics of obese adults that determine and define the success of weight management programs. We propose to use Item Response Theory (IRT) and Computerized Adaptive Testing (CAT) techniques to build a precise and short Patient-Reported Outcomes (PRO) instrument (OBESITY-CAT) to measure the impact of being obese on health-related quality of life (HRQOL) and self-efficacy expectations. CATs tailor the questions administered to each individual respondent, thereby increasing the precision and range of measurement without increasing respondent burden. In Phase I we propose to: (1) construct two item banks to measure the impact of obesity on HRQOL and the self-efficacy expectation to control weight, (2) develop a comprehensive and flexible OBESITY-CAT software solution, including immediate feedback reporting, and (3) pilot test the new tool in comparison with traditional full-length static questionnaires. To achieve these aims, we have partnered with Magellan Health Services, one of the nations' largest managed care organizations, serving 40 million individuals. Together we will develop obesity-specific items tailored particularly for the CAT process, analyze the item parameters in a sample of 1,000 of their employees (~ 75% being overweight or obese), and finally test the feasibility and acceptance of the OBESITY-CAT integrated into Magellan's nationwide weight management program in 100 participants. The product of Phase I will be a prototype comprehensive OBESITY-CAT with preliminary evidence regarding feasibility, acceptability, and empirical performance. In Phase II, the tool will be improved and further evaluated in terms of validity, reliability, and responsiveness, and its potential for use in predicting and monitoring treatment success, and the tool will be evaluated and programmed to be fully operational on different platforms, including PDAs and Interactive Voice Recognition (IVR). By greatly lowering data collection costs, reducing response burden, eliminating "ceiling" and "floor" effects and increasing the precision of individual scores, routine monitoring of HRQOL may become feasible as a clinical tool among obese adults. The Obesity-CAT will be able to monitor the success of weight management programs to increase the health related quality of life of overweight and obese adults. In addition, it will support tailoring weight management programs to the individual, and identify those which are at higher risk to drop-out of the program and need special attention. Compared to existing instruments, it will greatly lower data collection costs, reduce response burden, and increase the precision of individual scores, so that routine monitoring of HRQOL may become feasible as a clinical tool among obese adults.