Developing effective and sustainable interventions to increase key health behaviors remains a critical issue in health promotion for people with disabilities. Our current research uses a personalized intervention approach with telephone coaching support to achieve increases in physical activity participation, lowering of body mass index (BMI), and reduced healthcare utilization. The proposed project will expand the scope of this promising research by (1) training multiple wellness coaches in the implementation of the intervention; (2) using a computer-assisted system to conduct baseline assessment, facilitate goal development, identify local resources, and monitor progress; (3) adding a nutrition component to examine the additive effects on health outcomes; and (4) recruiting a more diverse sample of persons with mobility disabilities from multiple sites. 228 obese individuals with mobility disabilities (spinal cord injury, multiple sclerosis, cerebral palsy, spina bifida) will be randomized into one of three conditions: (1) PEP-II, Personalized Physical Activity Program involving physical activity telephone coaching only; (2) PEP Plus, Personalized Physical Activity and Nutrition coaching; and (3) control group. Eligibility criteria include (a) permission from physician to participate in the study; (b) BMI of 30-40; (c) have the ability to converse in English; (d) not enrolled in another health promotion program; and (e) sedentary lifestyle over the previous six months. Primary outcomes include physical activity, nutrition, self-efficacy, blood pressure, blood lipids, and healthcare utilization costs. Intervention group participants will receive wellness telephone coaching in the following phases: (a) 0-6 months (Adoption) - weekly coaching; (b) 7-12 months (Maintenance) - bimonthly to monthly coaching; (c) 12-18 months (Follow up) - no coaching. We hypothesize that relative to controls, the intervention groups will evidence significant gains on measures of physical activity, nutrition intake, and self- efficacy, as well as significant reduction in healthcare utilization, BMI, blood pressure and blood lipids. On these same outcome measures, participants in the PEP Plus group are hypothesized to evidence significant gains relative to their PEP-II counterparts. Intention-to-treat analysis will be conducted using a series of mixed models that will compare the three treatment groups over time (pre-test and six, 12 and 18-month post-test). ? ? ?
| Rimmer, James H; Wang, Edward; Pellegrini, Christine A et al. (2013) Telehealth weight management intervention for adults with physical disabilities: a randomized controlled trial. Am J Phys Med Rehabil 92:1084-94 |
| Rimmer, James H; Rauworth, Amy; Wang, Edward et al. (2009) A randomized controlled trial to increase physical activity and reduce obesity in a predominantly African American group of women with mobility disabilities and severe obesity. Prev Med 48:473-9 |
