Improving weight management at the VA: Enhancing the MOVE!23 for primary care

描述（由申请人提供）： 在这份导师职业发展奖（CDA-2）的申请中，Melanie Jay，MD，MS描述了她计划进行培训和研究，以实现她的长期目标，即成为一名独立的，临床导向的，致力于改善退伍军人健康管理局（VHA）肥胖症的治疗和预防的翻译研究员。她的具体和培训目标解决了一个假设，即在初级保健中治疗肥胖症的简短的计算机辅助干预将是可行的，并为患者和提供者所接受，并导致中间（即患者自我效能，意图和改变生活方式行为的动机），行为（饮食和身体活动改善）和减肥结果的改善。在Scott谢尔曼，MD，MPH的赞助下，培训计划利用VA纽约港医疗保健系统（HCS），纽约大学和NIH赞助的纽约肥胖营养研究中心的资源，结合正式的课程，指导阅读和体验部分。该计划涉及关键领域的指导和教学指导，包括定性方法，行为改变理论，实施科学，临床试验设计和实施，肥胖创新，数字媒体设计，高级统计分析，赠款写作和研究传播。杰伊博士提出了一个三阶段的项目，以提高VA移动! 23软件应用程序，以便它可以作为目标设定干预的一部分，在初级保健中治疗obesit。然后，她将评估这种干预措施，以便它可以被采用，以服务于更广泛的初级保健退伍军人人口。在形成阶段，她将使用定性方法来告知MOVE的增强! 23软件和干预的发展。在发展阶段，她将加强移动! 23软件应用和开发以及试点测试干预措施的其他组成部分。然后，她将申请临床转化科学机构（CTSI）和/或基金会资助，以帮助支持 项目的评估阶段。在评估阶段，她将在VA纽约港HCS初级保健诊所进行一项试点研究，以测试这种干预的可行性、可接受性并探索初步结果。她还将探讨可行性方面的差异 以及在干预中加入电话咨询的结果。她将招募140名受试者。所有受试者将获得增强的移动! 23和患者对齐护理团队（PACT）咨询。然后，他们将被随机分为两个干预组：仅PACT咨询或PACT咨询加上额外的电话咨询支持。她将探索每组内6个月和12个月前和后的可行性、可接受性以及中间、行为和体重减轻结果的差异，并比较两个干预组。本研究和培训计划将生成用于开发Merit Review应用程序的试点数据，以进行干预的3组随机对照试验。

DESCRIPTION (provided by applicant): Project Summary In this application for a Mentored Career Development Award (CDA-2), Melanie Jay, MD, MS describes her plan to pursue training and research to achieve her long-term goal of becoming an independent, clinically- oriented, translational investigator dedicated to improving the treatment and prevention of obesity at the Veterans Health Administration (VHA). Her specific and training aims address the hypothesis that a brief, computer-assisted intervention to treat obesity in primary care will be feasible and acceptable to patients and providers and result in improvements in intermediate (i.e. patient self-efficacy, intention, and motivation to change lifestyle behaviors), behavioral (diet and physical activity improvements), and weight-loss outcomes. Under the sponsorship of Scott Sherman, MD, MPH, the training plan capitalizes on the resources of the VA New York Harbor Healthcare System (HCS), New York University, and the NIH-sponsored New York Obesity Nutrition Research Center, combining formal coursework, directed readings, and experiential components. The plan involves mentorship and didactic instruction in key areas including qualitative methodology, behavior change theories, implementation science, clinical trial design and implementation, obesity innovations, digital media design, advanced statistical analysis, grant writing, and research dissemination. Dr. Jay proposes a three-phased project to enhance the VA MOVE!23 software application so that it can be used as part of a goal- setting intervention to treat obesit in primary care. She will then evaluate this intervention so that it can be adopted to serve the broader primary care Veteran population. During the Formative Phase, she will use qualitative methodologies to inform enhancement of the MOVE!23 software and development of the intervention. During the Development Phase, she will enhance the MOVE!23 software application and develop and pilot-test other components of the intervention. She will then apply for a Clinical Translational Science Institution (CTSI) and/or foundation grant to help support the Evaluation Phase of her project. During the Evaluation Phase, she will conduct a pilot study at the VA New York Harbor HCS primary care clinics to test the feasibility, acceptability, and explore preliminary outcomes of this intervention. She will also explore differences in feasibility and outcomes when telephone counseling is added to the intervention. She will recruit 140 subjects. All subjects will receive the enhanced MOVE!23 and Patient Aligned Care Team (PACT) counseling. They will then be randomized into two intervention arms: PACT counseling only or PACT counseling plus additional telephone counseling support. She will explore differences in feasibility, acceptability, and intermediate, behavioral, and weight loss outcomes at 6 and 12 months pre- and post- within each arm and comparing the two intervention arms. This research and training plan will generate pilot data for the development of a Merit Review application to conduct a 3-arm randomized controlled trial of the intervention.