The goal of this National Research Service Award (F32) is to prepare Kathryn Middleton to become an independent researcher studying the comparative cost-effectiveness of behavioral treatments for obesity and the dissemination of effective behavioral weight management techniques to public-health level interventions. Through a combination of didactic and direct mentored training experiences, this training plan will provide her with skills and knowledge in the following areas: assessment and treatment of obesity;the methodology, statistics, and ethics of clinical trials research;and techniques for comparative cost-effectiveness analysis. Kathryn Middleton will work closely with her distinguished mentor, Dr. Rena Wing, and project consultant, Dr. Pedro Goal, throughout the course of this award. The resources at the Warren Alpert Medical School of Brown University and The Miriam Hospital's Weight Control and Diabetes Research Center, combined with the expertise of her mentor will provide Kathryn Middleton with the ideal environment to achieve her training goals and transition to an independent researcher. Obesity remains a significant public health problem. Current treatments are effective but costly and have limited reach. New self-monitoring technology offers promise for helping larger groups of individuals lose weight;however, little research has been conducted on this technology. It is unknown whether this technology, in and of itself, is sufficient to produce weight loss or if it must be combined with interventionist contact. For the current project, 84 overweight and obese individuals will be randomized to a self-care control group, a technology condition, or a technology plus interventionist contact condition. The primary aim of this study is to assess the impact of this new self-monitoring technology, with and without interventionist contact, in comparison to a self-care control group, on weight loss at 6 months. The secondary aim of this study is to conduct a preliminary cost-effectiveness analysis on intervention components. The results from this study will be used in a future K award grant application to fund a fully-powered randomized trial assessing the efficacy and cost-effectiveness of new self-monitoring technology, delivered with and without interventionist contact. Completion of the current proposed project will allow Kathryn to develop skills in obesity assessment treatment, clinical trial development and analysis, and assessment and analysis of intervention costs and cost- effectiveness. Coursework in health economics, combined with a 3-day intensive seminar in cost-effectiveness analysis, will prepare Kathryn to conduct a preliminary cost-effectiveness analysis using data from the current project, which will give her the skills to conduct a full cost-effectiveness analysis on the future fully-powered randomized trial. These skills in obesity treatment and cost-effectiveness research will allow the applicant to continue on to a career as an independent researcher investigating methods to translate effective behavioral weight management treatments to public-health level interventions.
The current project addresses key issues in the development of public health approaches to the treatment of obesity, including 1) whether new self-monitoring technology, in and of itself, can lead to significant weight loss or if this technology must be combined with interventionist contact, and 2), the cost-effectiveness of each of these approaches compared to a self-care control condition. The results of this study will provide a foundation upon which the applicant will build a programmatic line of research focused on the translation of behavioral weight management programs into public-health level interventions.