Personalized Physical Activity & Nutrition Intervention for Overweight/Obese.....

描述（由申请人提供）：制定有效和可持续的干预措施，以增加关键的健康行为，仍然是促进残疾人健康的关键问题。我们目前的研究采用个性化的干预方法，通过电话指导支持来增加身体活动的参与，降低身体质量指数（BMI），并减少医疗保健利用率。本计划将透过(1)训练多名健康教练实施干预措施，扩大这项有前景的研究的范围；(2)利用计算机辅助系统进行基线评估，促进目标的制定，确定本地资源，并监测进度；(3)添加营养成分，以检验对健康结果的附加效应；(4)从多个地点招募更多样化的行动障碍人士样本。228名患有行动障碍（脊髓损伤、多发性硬化症、脑瘫、脊柱裂）的肥胖个体将被随机分为三种情况：(1)PEP-II，个性化体育活动计划，仅包括体育活动电话指导；(2) PEP Plus，个性化体育活动和营养指导；(3)对照组。入选标准包括：(a)医师同意参与研究；(b) BMI在30-40之间；(c)具备用英语交谈的能力；(d)未参加其他健康促进计划；(e)过去六个月的久坐生活方式。主要结局包括身体活动、营养、自我效能、血压、血脂和医疗保健利用成本。干预组参与者将在以下阶段接受健康电话辅导：(a) 0-6个月（收养）-每周辅导；(b) 7-12个月（维修）-每两个月至每月辅导；(c) 12-18个月（随访）-没有指导。我们假设，相对于对照组，干预组将在体力活动、营养摄入和自我效能方面取得显著进展，并在医疗保健利用、BMI、血压和血脂方面显著降低。在这些相同的结果测量中，假设PEP Plus组的参与者相对于PEP- ii组的参与者有显著的获益。意向治疗分析将使用一系列混合模型进行，这些模型将在一段时间内（测试前和测试后6个月、12个月和18个月）比较三个治疗组。

DESCRIPTION (provided by applicant): Developing effective and sustainable interventions to increase key health behaviors remains a critical issue in health promotion for people with disabilities. Our current research uses a personalized intervention approach with telephone coaching support to achieve increases in physical activity participation, lowering of body mass index (BMI), and reduced healthcare utilization. The proposed project will expand the scope of this promising research by (1) training multiple wellness coaches in the implementation of the intervention; (2) using a computer-assisted system to conduct baseline assessment, facilitate goal development, identify local resources, and monitor progress; (3) adding a nutrition component to examine the additive effects on health outcomes; and (4) recruiting a more diverse sample of persons with mobility disabilities from multiple sites. 228 obese individuals with mobility disabilities (spinal cord injury, multiple sclerosis, cerebral palsy, spina bifida) will be randomized into one of three conditions: (1) PEP-II, Personalized Physical Activity Program involving physical activity telephone coaching only; (2) PEP Plus, Personalized Physical Activity and Nutrition coaching; and (3) control group. Eligibility criteria include (a) permission from physician to participate in the study; (b) BMI of 30-40; (c) have the ability to converse in English; (d) not enrolled in another health promotion program; and (e) sedentary lifestyle over the previous six months. Primary outcomes include physical activity, nutrition, self-efficacy, blood pressure, blood lipids, and healthcare utilization costs. Intervention group participants will receive wellness telephone coaching in the following phases: (a) 0-6 months (Adoption) - weekly coaching; (b) 7-12 months (Maintenance) - bimonthly to monthly coaching; (c) 12-18 months (Follow up) - no coaching. We hypothesize that relative to controls, the intervention groups will evidence significant gains on measures of physical activity, nutrition intake, and self- efficacy, as well as significant reduction in healthcare utilization, BMI, blood pressure and blood lipids. On these same outcome measures, participants in the PEP Plus group are hypothesized to evidence significant gains relative to their PEP-II counterparts. Intention-to-treat analysis will be conducted using a series of mixed models that will compare the three treatment groups over time (pre-test and six, 12 and 18-month post-test).