The Institute of Medicine gives top priority to identifying effective methods of treating obesity in at-risk populations such as the urban poor. Community health centers (CHC) provide primary care to persons regardless of ability to pay and under health care reform will be providing care to a large proportion of urban poor. To date, the most effective weight loss interventions have had frequent staff-patient interactions, high attendance, and physical activity. Such intensive interventions are a challenge for CHCs because they are chronically short staffed and have limited space. And, CHC patients often have limited transportation. Video-conferencing requires very little CHC space, and may reduce staff time and patient transportation needs. A single staff person can lead meeting sessions for patients located virtually anywhere. Although building an intervention for lower income populations based on broadband Internet may seem counterintuitive, broadband is available in most all urban areas. Additionally, on March 17, 2010, the FCC delivered a 10-year National Broadband Plan to Congress to bring high-speed Internet to 90% of U.S. homes. We have successfully piloted a multiparty video-conference weight loss program delivered to CHC patients in their homes using simple hardware and Internet access supplied by the project. We have used an exercise protocol tailored to obese CHC patients and well-established nutrition education and support materials modified for a participant population that includes persons with low literacy and numeracy skills. For the proposed efficacy trial we will randomize 150 adult CHC patients with body-mass index e30 and <50 to either an in-person weight loss program, a video-conference delivered weight loss program, or to a usual care control group. We hypothesize that, compared to usual care, 30% more persons in each of the active arms will have a clinically significant weight loss (e2 kg) at 6-months, and will maintain this weight loss a 12-months. Attendance and intervention costs will be compared between intervention arms and cost-effectiveness will be estimated for all three study arms. This work could result in an effective and accessible weight loss intervention that could be widely and rapidly disseminated through CHCs and broadband Internet.

Public Health Relevance

This project will test whether twice-weekly weight loss classes delivered either in-person or via video-conference lead to greater weight loss than usual care. Participants will be obese, middle-aged patients of community health centers. Classes consist of progressive exercise and nutrition education designed for a population with a range of literacy and numeracy skills.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK092377-02
Application #
8452677
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Kuczmarski, Robert J
Project Start
2012-04-03
Project End
2016-03-31
Budget Start
2013-04-01
Budget End
2014-03-31
Support Year
2
Fiscal Year
2013
Total Cost
$544,704
Indirect Cost
$103,148
Name
Indiana University-Purdue University at Indianapolis
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
603007902
City
Indianapolis
State
IN
Country
United States
Zip Code
46202