Improving Obesity Self-care Among Mentally Ill Veterans

描述(由申请人提供) 研究项目简介：肥胖是退伍军人中一个日益严重的健康问题，与慢性病、残疾和早期死亡率的风险增加有关。与那些没有精神疾病的人相比，患有精神疾病的肥胖退伍军人在体重管理方面遇到了更大的困难。心理变量对肥胖自我照顾习惯的参与和维持造成了障碍。抑郁和焦虑症状的减少与成功的体重管理有关，这反过来又可以改善健康状况。尽管有很高的共存率和证据将精神健康症状的改善与提高参与度和保持适当的体重管理联系在一起，但大多数肥胖症自我护理干预措施对改善共存的焦虑和抑郁症状提供的关注很少或根本没有。拟议的研究项目将：(1)检查参与的心理障碍、坚持和基于证据的体重管理计划的结果(MOVE！)以及(2)将抑郁症和焦虑症的治疗融入Move！以提高保留率、依从性和随后的减肥效果。我之前的研究、临床和指导经验使我独一无二地准备进行这项研究。候选人的近期和长期职业目标：我的总体职业目标是将自己确立为一名独立的康复研究人员，在肥胖退伍军人中拥有体重管理方面的专业知识，并同时患有精神疾病。我的短期职业目标包括获得RR&D CDA-2奖项，该奖项将提供所需的保护时间以及临床、指导和研究经验，以促进发展成为一名独立的康复研究人员。我的长期研究目标是修改基于证据的体重管理策略，以改善身体健康结果、临床实践和针对残疾风险最大的肥胖退伍军人的政策。研究生涯发展计划的关键要素：我将获得更多的教学和指导经验，以扩大我在开发和测试循证肥胖自我护理行为干预方面的专业知识，使用临床试验方法将心理健康治疗整合到体重管理干预措施中，了解如何在退伍军人康复护理系列和退伍军人康复与发展项目中整合循证体重管理策略，并获得RR&D IIR荣誉奖，以实现研究独立性。设施和其他资源：我有幸成为医学系初级BCM教员，在休斯顿护理和利用研究质量研究中心(COE)担任初级教员，在动脉粥样硬化和血管医学方面担任次要职务，并成为Michael E.DeBakey VA医学中心的MIRECC研究员。每个设置都有自己独特的资源可供我使用。其中一些资源包括电子图书馆访问、研究和职业发展教学和研讨会、统计学家、几名国家卫生研究院和退伍军人事务部高级调查人员、赠款撰写研讨会以及各种软件包。

DESCRIPTION (provided by applicant) Description of the research project: Obesity is an escalating health problem among Veterans that is associated with increased risk of chronic disease, disability and early mortality rates. Obese Veterans with co-existing mental illness experience greater difficulties with weight management in comparison to those without mental illness. Psychological variables create barriers to engagement and maintenance of obesity self-care habits. Decreased symptoms of depression and anxiety have been associated with successful weight management which in turn can lead to improved health status. Despite the high coexistence rates and evidence linking improvements in mental health symptoms to improved engagement and maintenance of appropriate weight management, most obesity self-care interventions provide minimal to no attention to improving co-existing anxiety and depression symptoms. The proposed research projects will: (1) examine psychological barriers to participation, adherence and outcomes of an evidenced based weight management program (MOVE!) and (2) integrate depression and anxiety treatment into MOVE! to improve retention rates, adherence and subsequent weight loss. My previous research, clinical and mentorship experiences make me uniquely poised to conduct this study. Candidate's immediate and long-term career goals: My overall career aim is to establish myself as an independent rehabilitation researcher with expertise in weight management among obese Veterans with co-existing mental illnesses. My short term career goals include securing a RR&D CDA-2 award that will provide the needed protected time and clinical, mentoring and research experiences to advance develop into an independent rehabilitation researcher. My long-term research goals are to modify evidenced based weight management strategies to improve physical health outcomes, clinical practice, and policy for obese Veterans at the greatest risk for disability. Key elements of the research career development plan: I will receive additional didactic and mentorship experiences to expanding my expertise in developing and testing evidence based obesity self-care behavioral interventions, integrating mental health treatments into weight management interventions using clinical trial methodology, gaining an understanding how to integrate evidenced based weight management strategies in a VA rehabilitation care line and VA RR&D project, and secure an RR&D IIR Merit award to attain research independence. Facilities & Other Resources: I am fortunate to be a junior BCM faculty member in the department of medicine with a primary appointment in the Houston Center for Quality of Care and Utilization Studies (COE) and secondary appointment in Atheroscleorsis and Vascular Medicine and to be an MIRECC Investigator for the Michael E. DeBakey VA Medical Center. Each setting has its own unique resources that are available for my use. Some of these resources include, electronic library access, research and career development didactics and workshops, statisticians, several senior NIH and VA investigators, grant writing workshops, and a variety of software packages.