Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) Veteran Preferences for and Feasibility of Automated Physical Activity Interventions: A Pilot Study

This is a pilot study designed to better understand what elements/strategies help to engage Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) veterans in an e-health program for promoting weight loss and increasing physical activity. These data will be used as pilot information for a larger study to assess the effectiveness of using an e-health approach to promote weight loss and increase physical activity among post-deployment OEF/OIF veterans who are at risk for developing diabetes. Additionally, we seek to recognize any effects of the intervention on other health-related outcomes, such as stress, depression or other mental health measures, chronic pain, sleep, quality of life, satisfaction with care/ Veteran Affairs Health system, employment status, social support/connectedness.

Post-deployment OEF/OIF veterans worry about gaining weight and believe regular physical activity is beneficial, yet many don't exercise due to health problems and/or chronic pain. Healthy eating combined with physical activity are key strategies in maintaining or losing weight and is important in preventing diabetes, cardiovascular disease and other preventable illnesses as well as managing many mental health conditions and reducing chronic pain symptoms. In addition, maintaining or improving physical activity/exercise may be an effective strategy for addressing other post-deployment issues: stress, social issues.

E-health strategies may be an effective and potentially preferred as well as efficient (cost-effective) way to deliver or assist OEF/OIF veterans with health and lifestyle related health behaviors. There is a growing array of e-health tools, technologies and approaches to assist people with diet-related issues (for weight loss or maintaining a healthy weight) and to encourage physical activity. This includes cell phone applications, objective monitoring devices such as pedometers and web-based programs (as well as combination of these different strategies). However, the most effective and efficient way to encourage healthy eating and weight loss/maintenance or promote physical activity remains an open question and which tools and technologies might best engage the OEF/OIF veteran population in addressing these lifestyle issues is yet to be determined.

OEF/OIF Coordinators will include the study recruitment flyer in their initial informational mailing to new OEF/OIF veterans and publish the flyer in their monthly newsletter. The recruitment flyer will encourage interested veterans to contact study staff via a toll free number (where they will leave a message) or email. During one-on-one meetings, Coordinators will identify overweight and obese OEF/OIF veterans who are interested in losing weight with physical activity and with the veterans permission will forward the veterans name and phone number to the research study staff by leaving a voice mail on the study phone line. During these meetings, the OEF/OIF Coordinators will also provide basic information regarding the program and provide the Veteran a recruitment flyer. Recruitment flyers will also be posted at strategic locations around the VA with the approval of Public Affairs. Should study staff fail to meet recruitment goals through the assistance of the OEF/OIF Coordinators and posted flyers, primary care physicians (PCPs) will also be educated on the study and given study recruitment flyers to give to potentially eligible patients. With the permission of the veteran, PCPs will forward the veterans name and phone number to the research study staff by leaving a voicemail on the study phone line.

Potential participants will be contacted by phone to be screened for eligibility. If eligible, participant will be asked to come to the Ann Arbor Veterans Affairs Healthsystem (VA) for a 1 ½ to 2 hour enrollment session. Patients will be consented at the start of this enrollment visit, prior to the commencement of any research activities.