Online Counseling to Enable Lifestyle-focused Obesity Treatment in Primary Care
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 360
- 试验地点
- 2
- 主要终点
- Change in body weight (Kg)
研究概览
简要总结
With over half of the US population currently overweight and 31% of adults now obese, the primary care setting may represent an important source of weight-loss support, in the interest of cardiovascular prevention. Yet, although the US Preventive Services task force recommends that physicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults, the recommendation has not been widely implemented. The Internet may help overcome many of the barriers that have prevented intensive obesity counseling in the clinical setting. The aim of this study is to examine whether Internet-based interventions for developing healthier lifestyles can improve preventive health care in a cost-effective manner.
详细描述
The study, Online counseling to enable lifestyle-focused obesity treatment in primary care, aims to translate an evidence-based lifestyle intervention into the primary care setting, using information technology to enable clinical lifestyle counseling. While the US Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults, multiple barriers to intensive lifestyle counseling exist and the recommendation has not been widely implemented. By requiring physician referral, augmenting the health care team's access to behavioral expertise, and encouraging physician feedback to participating patients, we aim to integrate lifestyle issues into routine preventive medicine. We will examine change in weight, waist circumference, physical activity, quality of life, and will calculate intervention cost-effectiveness. We will ensure sustainability by using recruitment and adherence strategies that can be replicated in routine practice, and counseling staff who are representative of the educators employed in primary care practice. If an online strategy is effective, the extensive network of the University of Pittsburgh Medical Center Health System provides excellent infrastructure for supporting dissemination in the region. As such, this study may facilitate wide-spread adoption of current evidence-based preventive medicine guidelines recommending incorporation of intensive lifestyle interventions into primary care practice.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 21 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Obese (BMI > 30kg/meters squared)
- •Age 21-75
- •Receives primary care at a participating primary care clinic in the Pittsburgh, PA area
排除标准
- •Primary care physician determination that moderate physical activity is not safe or appropriate for the patient
- •Pregnancy
- •Planned pregnancy in the next 2 years
- •Current breast-feeding
- •Bariatric surgery in the past 2 years
- •Planned bariatric surgery in the next 2 years
- •Edematous state that interferes with body weight assessment
- •Health condition that is likely to influence body weight
- •Heart attack within the past 3 months
- •Regular use of prescription medication that is likely to influence body weight
- •participation during the past year in either of the pilot programs for this study
- •perceived lack of basic computer or Internet skills
- •Inability to learn adequately from English language audio-recorded materials
- •Lack of access to a scale
- •Inability to attend an Orientation session
结局指标
主要结局
Change in body weight (Kg)
时间窗: 1 year
次要结局
- Change in health-related quality of life as measured by the RAND-36 PCS or MCS(1 year)
- Change in BMI (kg/m2)(1 year)
- Change in total score on IWQol-Lite(1 year)
- Change in steps per day(1 year)
- % with >70 meter increase on 6-minute walk(1 year)
- % obtaining >7% weight loss(1 year)
- Change in waist circumference(1 year)
- Change in blood pressure (mm Hg)(1 year)
研究者
Kathleen McTigue
Assitant Professor
University of Pittsburgh