OCELOT-PC: Online Counseling to Enable Lifestyle-focused Obesity Treatment in Primary Care
Study Details
Study Description
Brief Summary
With over half of the US population currently overweight and 31% of adults now obese, the primary care setting may represent an important source of weight-loss support, in the interest of cardiovascular prevention. Yet, although the US Preventive Services task force recommends that physicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults, the recommendation has not been widely implemented. The Internet may help overcome many of the barriers that have prevented intensive obesity counseling in the clinical setting. The aim of this study is to examine whether Internet-based interventions for developing healthier lifestyles can improve preventive health care in a cost-effective manner.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 2/Phase 3 |
Detailed Description
The study, Online counseling to enable lifestyle-focused obesity treatment in primary care, aims to translate an evidence-based lifestyle intervention into the primary care setting, using information technology to enable clinical lifestyle counseling. While the US Preventive Services Task Force (USPSTF) recommends that clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults, multiple barriers to intensive lifestyle counseling exist and the recommendation has not been widely implemented. By requiring physician referral, augmenting the health care team's access to behavioral expertise, and encouraging physician feedback to participating patients, we aim to integrate lifestyle issues into routine preventive medicine. We will examine change in weight, waist circumference, physical activity, quality of life, and will calculate intervention cost-effectiveness. We will ensure sustainability by using recruitment and adherence strategies that can be replicated in routine practice, and counseling staff who are representative of the educators employed in primary care practice. If an online strategy is effective, the extensive network of the University of Pittsburgh Medical Center Health System provides excellent infrastructure for supporting dissemination in the region. As such, this study may facilitate wide-spread adoption of current evidence-based preventive medicine guidelines recommending incorporation of intensive lifestyle interventions into primary care practice.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: VLM-S Participants in this arm receive "standard" lifestyle coaching, which is delivered on a specified schedule. They will also receive online information about evidence-based lifestyle goals and links to reputable resources for helping to achieve a healthy lifestyle. |
Behavioral: VLM-S
Online program for weight loss - standard
|
| Experimental: VLM-M Participants in this arm receive "modulated" lifestyle coaching, where coaching frequency may be adjusted according to whether the participant is meeting program goals for program use and targeted behaviors. They will also receive online information about evidence-based lifestyle goals and links to reputable resources for helping to achieve a healthy lifestyle. |
Behavioral: VLM-M
Online program for weight loss - modulated
|
| Active Comparator: OGR Participants in this arm will receive online information about evidence-based lifestyle goals and links to reputable resources for helping to achieve a healthy lifestyle, but not personalized lifestyle coaching. |
Behavioral: OGR
Online program for weight loss - resources
|
Outcome Measures
Primary Outcome Measures
- Change in body weight (Kg) [1 year]
Secondary Outcome Measures
- % obtaining >7% weight loss [1 year]
- Change in BMI (kg/m2) [1 year]
- Change in waist circumference [1 year]
- Change in steps per day [1 year]
- Change in health-related quality of life as measured by the RAND-36 PCS or MCS [1 year]
- Change in total score on IWQol-Lite [1 year]
- % with >70 meter increase on 6-minute walk [1 year]
- Change in blood pressure (mm Hg) [1 year]
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Obese (BMI > 30kg/meters squared)
-
Age 21-75
-
Receives primary care at a participating primary care clinic in the Pittsburgh, PA area
Exclusion Criteria:
-
Primary care physician determination that moderate physical activity is not safe or appropriate for the patient
-
Pregnancy
-
Planned pregnancy in the next 2 years
-
Current breast-feeding
-
Bariatric surgery in the past 2 years
-
Planned bariatric surgery in the next 2 years
-
Edematous state that interferes with body weight assessment
-
Health condition that is likely to influence body weight
-
Heart attack within the past 3 months
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Regular use of prescription medication that is likely to influence body weight
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participation during the past year in either of the pilot programs for this study
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perceived lack of basic computer or Internet skills
-
Inability to learn adequately from English language audio-recorded materials
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Lack of access to a scale
-
Inability to attend an Orientation session
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of Pittsburgh | Pittsburgh | Pennsylvania | United States | 15213 |
Sponsors and Collaborators
- University of Pittsburgh
- Agency for Healthcare Research and Quality (AHRQ)
Investigators
- Principal Investigator: Kathleen M McTigue, MD, MS, MPH, University of Pittsburgh
Study Documents (Full-Text)
None provided.More Information
Publications
- 1R18HS018155