Teaching Obesity Treatment Options to Adult Learners Intervention Via VA Video Connect
Condition: Overweight and Obesity
MeSH terms: Obesity; Overweight
Study type: Interventional

Summary: 
      The goal of this study is to assess the feasibility and acceptability of Teaching Obesity
      Treatment Options to Adult Learners (TOTAL intervention), which includes an educational video
      about obesity treatment options within VA in conjunction with three telemedicine motivational
      sessions to increase obesity treatment initiation. 10 participants will be recruited from the
      Madison VA Medical Center. Participation involves 3.5 hours of total time with study follow
      up to 18 months.
    

Detailed description: 
      Obesity is the second leading cause of death in the U.S. The treatment of obesity and its
      related comorbidities, including cardiovascular disease and diabetes, exceeds $150 billion
      annually. "Morbidly" or "severely" obese patients, defined by a body mass index (BMI) of 35
      kg/m² or greater, are especially high risk for serious complications due to the metabolic and
      physiologic derangements that occur with severe obesity. Within the Veterans Health
      Administration (VA) system, nearly 600,000 patients are severely obese. These Veterans exert
      significant costs on the VA system, experience poorer quality of life, and have shortened
      lifespans. Bariatric surgery is the most effective treatment for severe obesity for weight
      loss, comorbidity resolution, and quality of life. Bariatric surgery is supported as a
      treatment option by many national societies, including those representing primary care and
      endocrinology. However, less than 1% of Veterans who qualify for bariatric surgery undergo
      it. The investigator's previous research indicates that two important barriers to obesity
      treatment participation are poor Veteran knowledge about the risks of obesity and obesity
      treatment options, and lack of Veteran motivation.

      The goal of this study is to assess the feasibility and acceptability of Teaching Obesity
      Treatment Options to Adult Learners (TOTAL intervention) among Veterans with
      overweight/obesity who are not participating in MOVE! program (a Weight Management Program,
      supported by VA's National Center for Health Promotion and Disease Prevention (NCP). The
      primary outcomes will be recruitment and retention rates and acceptability of TOTAL. The
      secondary outcomes include MOVE! program initiation sustained MOVE! participation, obesity
      medication receipt, bariatric surgery referral, and weight loss 18 months post-intervention.

      The investigators propose to pilot test the TOTAL intervention for up to 10 Veterans with
      overweight/obesity who are not currently participating in MOVE!. Once participants are
      consented and baseline data are obtained, participants will view the TOTAL video and
      participate in three one-on-one, 30-minute motivational sessions via VVC at 1-week, 6-months,
      and 12-months. All VVC sessions will be audio recorded. This timing was selected so Veterans
      would have regular interactions with the interventionist within one year of initiating the
      intervention. Each motivational session will be tailored to where Veterans are in the
      treatment initiation process. Further, the investigators will conduct 15-minute participant
      interviews after each motivational session to assess how the TOTAL educational video and the
      motivational sessions are received by Veterans using VVC. These interviews will not be
      audio-recorded. Lastly, participants will complete a brief post-assessment at the 18-month
      visit to obtain information about their obesity initiation/treatment as well as their final
      weight.
    

Intervention name(s): TOTAL with Motivational Telemedicine Sessions
Intervention type(s): Behavioral
Intervention description(s): Teaching Obesity Treatment Options to Adult Learners Educational Video with 3, 30 minute motivational sessions at 1 week, 6 months, and 12 months after viewing video
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: telemedicine; Veterans Health Administration; VHA; behavioral weight management