Health Coaching & Technology in a Weight Loss Center
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 1/10/2019 |
| Start Date: | November 29, 2017 |
| End Date: | July 1, 2019 |
A Pilot Study of an eHealth-delivered Health Coaching Intervention
The national epidemic of obesity is associated with considerable morbidity, disability and
early mortality.
Conventional weight loss programs beyond a primary care setting have the potential to reduce
weight, but are difficult to access for adults with obesity in rural areas due to lack of
transportation and access to specialty care. Routine intensive behavioral therapy, while
effective, is often not supplemented with adjuncts that could be helpful in engaging
participants in behavioral change. The overarching goal of this SYNERGY pilot project is to
overcome barriers rural adults face by using video-conferencing to deliver specialty obesity
care that otherwise is inaccessible to most adults faced with this disease. It also intends
to use emerging mobile health (mHealth) technology which has shown considerable promise in
providing motivational feedback. This proposal highlights T3/T4 translation bridging
technologists, allied health staff, and clinicians in the development and implementation of
new therapeutic modalities. The study aims to evaluate a telehealth-based health coaching
program that is embedded in the Dartmouth-Hitchcock Weight and Wellness Center that
integrates novel remote monitoring technology in effecting behavioral change using Amulet, a
Dartmouth Computer Science developed mHealth device over a 16-week period. First, the
feasibility and accessibility of an eHealth-delivered health coaching obesity intervention
using remote monitoring and video-conferencing (Aim 1) will be evaluated. The potential
effectiveness of achieving the primary outcome of 5% weight loss, with secondary outcomes of
improved physical function and self reported health (Aim 2) will be ascertained. The
intervention's impact on implementation outcomes of workflow, adoption, and organizational
change that could affect further scalability and generalizability in other high-risk
population groups (Aim 3) will be assessed. These preliminary findings will be used in a
future competitive application for an extramural R01 designed to assess the effectiveness of
our intervention in achieving weight loss in rural obese adults. If successful, this
application has the potential to redesign care using applied methods of telehealth translated
to community-based, rural populations to facilitate behavioral change. The project also meets
criteria of the NIH Strategic Plan for Obesity and the Institute of Medicine's need for
Telehealth research.
early mortality.
Conventional weight loss programs beyond a primary care setting have the potential to reduce
weight, but are difficult to access for adults with obesity in rural areas due to lack of
transportation and access to specialty care. Routine intensive behavioral therapy, while
effective, is often not supplemented with adjuncts that could be helpful in engaging
participants in behavioral change. The overarching goal of this SYNERGY pilot project is to
overcome barriers rural adults face by using video-conferencing to deliver specialty obesity
care that otherwise is inaccessible to most adults faced with this disease. It also intends
to use emerging mobile health (mHealth) technology which has shown considerable promise in
providing motivational feedback. This proposal highlights T3/T4 translation bridging
technologists, allied health staff, and clinicians in the development and implementation of
new therapeutic modalities. The study aims to evaluate a telehealth-based health coaching
program that is embedded in the Dartmouth-Hitchcock Weight and Wellness Center that
integrates novel remote monitoring technology in effecting behavioral change using Amulet, a
Dartmouth Computer Science developed mHealth device over a 16-week period. First, the
feasibility and accessibility of an eHealth-delivered health coaching obesity intervention
using remote monitoring and video-conferencing (Aim 1) will be evaluated. The potential
effectiveness of achieving the primary outcome of 5% weight loss, with secondary outcomes of
improved physical function and self reported health (Aim 2) will be ascertained. The
intervention's impact on implementation outcomes of workflow, adoption, and organizational
change that could affect further scalability and generalizability in other high-risk
population groups (Aim 3) will be assessed. These preliminary findings will be used in a
future competitive application for an extramural R01 designed to assess the effectiveness of
our intervention in achieving weight loss in rural obese adults. If successful, this
application has the potential to redesign care using applied methods of telehealth translated
to community-based, rural populations to facilitate behavioral change. The project also meets
criteria of the NIH Strategic Plan for Obesity and the Institute of Medicine's need for
Telehealth research.
Inclusion Criteria:
- English speaking;
- Community-dwelling;
- Age 18-65 years;
- Obesity based on: BMI ≥30kg/m2 54;
- Participating in the DH-WWC health coach program;
- Access to home, high-speed internet with Wi-Fi;
- Medical clearance from their primary care provider;
- Provide voluntary, written consent;
- Require an EHR patient portal account and credentials ; -----If subjects do not have
an account, one will be created for the purposes of this study
Exclusion Criteria:
- Unwilling to participate in the 16 week pilot or complete study measures;
- Individuals unwilling/unable to provide consent;
- A medical record diagnosis of dementia as intensive behavioral therapy and health
coaching require the ability to complete questionnaires and change behavior, all of
which may be challenging in individuals with cognitive impairment;
- Cognitive impairment measured by the 6-item Callahan screen, a brief and reliable
six-item screening questionnaire with acceptable sensitivity (88.7%) and specificity
(88.0%) in identifying individuals with cognitive impairment. Its diagnostic
properties are comparable to the full Folstein Mini-Mental Status Examination in those
scoring ≥3. This questionnaire can be administered by telephone or face-to-face
interview and is being as an adjunct to medical record documentation of cognitive
impairment;
- Life-threatening illness including those receiving palliative care or hospice
services;
- Nursing facility or hospital admission in the past six months;
- Psychiatric diagnosis that would interfere with study participation and require
significant modification to meet their needs such as major depressive disorder,
substance abuse, suicidal ideation or severe mental illness (schizophrenia, bipolar
disorder);
- History of bariatric surgery;
- American College of Sports Medicine contraindications to exercise57 including: a
resting heart rate of >120bpm; Blood pressure >180/100mmHg; unstable angina;
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