Innovative Technology To Improve Patient Adherence To Weight Loss Recommendations
Condition: Obesity
MeSH terms: Weight Loss
Study type: Interventional

Summary: 
      The proposed project addresses the significant problem of obesity and uses innovative
      technology to improve adherence to a behavioral weight loss strategies. If the program is
      effective, it would provide an outstanding resource for physicians to use with their patients
      and thus would have tremendous clinical impact.
    

Detailed description: 
      Overweight/obesity is a major health problem that affects over two-thirds of Americans,
      increases morbidity and mortality and has annual medical costs exceeding $75 billion.
      Although many Americans indicate that they are trying to lose weight, adherence to weight
      loss regimens is often poor. Programs are needed that can improve adherence and weight loss
      for overweight/obese individuals. Physicians play an important role in motivating patients to
      improve health behaviors and recent reviews suggest that having physicians advise patients to
      lose weight and then referring patients to an effective program produces the best behavior
      change and maintenance. The problem, however, is that physicians currently have limited
      options for such referrals. The challenge for the field is to develop a program to which
      physicians can refer their overweight/obese patients. The program must be low cost, easily
      accessible, and must promote adherence to the weight loss regimen and consequently improve
      weight loss outcomes.

      The goal of this Challenge Grant application is to develop and test an innovative web-based
      program that would provide an accessible and effective approach to enhancing adherence to
      clinical recommendations for weight loss. If effective, the program would provide an
      outstanding resource for physicians and their patients and could consequently have important
      clinical and public health impact.

      We propose to develop a program based on our prior research that uses innovative Internet
      technology to provide a low cost, easily disseminated program that captures two critical
      elements of effective behavioral weight loss programs-namely, training in key behavioral
      weight control strategies and increased participant accountability. Patients, referred by
      their physician for weight loss, will be offered a 12 week program that they can view at
      their convenience on their computer. The program will use Web-based interactive multi-media
      approaches for presentation of the behavioral skills and provide a Web-based form for
      submission of self-monitoring and weight data; to maximize patient accountability, the
      program will include a system of automated feedback for participants, which comments on their
      weight loss to date and their performance within several behavioral weight-loss domains, with
      suggestions tailored to the characteristics and performance of the individual. Periodic
      reports on the patients' progress will also be sent to the referring physician. We will test
      this program in a randomized trial with 250 patients referred by their physicians who will be
      randomly assigned to either Internet Education (Control) (N=125) or to the Innovative
      Technology program (N=125). Participants in both groups will receive a 12 week Internet
      program of either basic weight loss education or the Innovative Technology program and will
      be weighed at the start and end of the 3 month program and at 3 month follow-up. The primary
      hypothesis is that patients who are assigned to the Innovative Technology program will
      achieve larger average weight losses than those in the control group over the 12-week
      program. Secondary hypotheses are that the Innovative technology group will adhere better
      over the 12-weeks (assessed by log-ins to the web site and self-reported changes in diet and
      activity) and achieve better weight losses at 6 months than the control group.

      The proposed project addresses the significant problem of obesity and uses innovative
      technology to improve adherence to a behavioral weight loss strategies. If the program is
      effective, it would provide an outstanding resource for physicians to use with their patients
      and thus would have tremendous clinical impact.
    

Intervention name(s): Diet and Activity Education; Self-monitoring with Feedback
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Education about behavioral modification of eating and activity habits for weight loss.; Participants self-monitor diet and activity behaviors, which are submitted via a website. Automated feedback on the self-monitoring record is provided to participants.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Obesity; Primary Care; Internet; Technology; Behavior Modification