ABSTRACT
INTRODUCTION: Intensive weight management programs are effective but often have low enrollment and high attrition. Lack of motivation is a key psychological barrier to enrollment, engagement, and weight loss. Mental Contrasting with Implementation Intentions (MCII) is a unique imagery technique that increases motivation for behavior change. We describe our study protocol to assess the efficacy and implementation of MCII to enhance the effectiveness of VA's MOVE! or TeleMOVE! weight management programs using a procedure called "WOOP" (Wish, Outcome, Obstacle, Plan) for Veterans. We hypothesize that WOOP+MOVE! or TeleMOVE! (intervention) will lead to greater MOVE!/TeleMOVE! program engagment and consequently weight loss than MOVE!/TeleMOVE! alone (control). METHOD: Veterans are randomized to either the intervention or control. Both arms receive the either MOVE! or TeleMOVE! weight management programs. The intervention group receives an hour long WOOP training while the control group receives patient education. Both groups receive telephone follow up calls at 3 days, 4 weeks, and 2 months post-baseline. Eligible participants are Veterans (ages 18-70 years) with either obesity (BMI ≥ 30 kg/m2) or overweight (BMI ≥ 25 kg/m2) and an obesity-associated co-morbidity. At baseline, 6 and 12 months, we assess weight, diet, physical activity in both groups. The primary outcome is mean percent weight change at 6 months. Secondary outcomes include changes in waist circumference, diet, physical activity, and dieting self-efficacy and engagement in regular physical activity. We assess implementation using the RE-AIM framework. CONCLUSION: If WOOP VA is found to be efficacious, it will be an important tool to facilitate weight management and improve weight outcomes. CLINICAL TRIAL REGISTRATION: NCT05014984.
Subject(s)
Intention , Motivation , Veterans , Weight Reduction Programs , Adult , Aged , Female , Humans , Male , Middle Aged , Body Mass Index , Exercise , Obesity/therapy , Patient Education as Topic/methods , Patient Education as Topic/organization & administration , Prospective Studies , United States , United States Department of Veterans Affairs , Veterans/psychology , Weight Loss , Weight Reduction Programs/methods , Weight Reduction Programs/organization & administration , Randomized Controlled Trials as TopicABSTRACT
Diabetes is the seventh leading cause of death in the United States. In 2010, about 1.9 million new cases of diabetes were diagnosed in people aged 20 years or older. Remote health monitoring systems can help diabetics and their healthcare professionals monitor health-related measurements by providing real-time feedback. However, data-driven methods to dynamically prioritize and generate tasks are not well investigated in the remote health monitoring. This paper presents a task optimization technique used in WANDA (Weight and Activity with Blood Pressure and Other Vital Signs); a wireless health project that leverages sensor technology and wireless communication to monitor the health status of patients with diabetes. WANDA applies data analytics in real-time to improving the quality of care. The developed algorithm minimizes the number of daily tasks required by diabetic patients using association rules that satisfies a minimum support threshold. Each of these tasks maximizes information gain, thereby improving the overall level of care. Experimental results show that the developed algorithm can reduce the number of tasks up to 28.6% with minimum support 0.95, minimum confidence 0.97 and high efficiency.