The proposed project is designed to develop and evaluate the effectiveness of two experimental interactive weight-management models that individualize treatment based on computer assessment. These weight- management models will be developed using multi-media to combine written and graphic materials through an interactive user-friendly touch-screen computer system. One model uses Computer Guided Intervention (CGI) alone, and the other uses Computer Guided Intervention plus Staff Consultation (CGI + SC). Using a computer system to identify needs and guide intervention will potentially maximize the use of staff consultation time. Our Computer Guided Intervention (CGI) for weight-management will address current behavior, psychological needs, cardiovascular risk status, and knowledge as well as body weight. In a randomized trial we will compare the cost-effectiveness of our two experimental models and two comparison interventions in a managed care setting. The 850 participants -will be randomized to: I) CGI alone, 2) CGI plus staff consultation (CGI + SC), 3) a workbook only (WO) as a minimal treatment condition, and 4) Usual Care Education (UCE) using the site's psychoeducational weight-control program. Our primary outcome will be weight change, and secondary end points will include changes in the Framingham cardiovascular risk equation and quality of life. These endpoints will be used to calculate the cost-effectiveness of each intervention. The purpose of our randomized trial is to evaluate the effectiveness-of replicable models derived from cognitive-behavioral approaches that can be implemented in a variety of clinical settings rather than to compare techniques for weight management.
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