The goal of this study is to conduct a program of pilot research aimed at developing and evaluating a technology-assisted wellness intervention for older adults with obesity.
The national epidemic of obesity is also affecting older adults, and is associated with an increased risk of disability, nursing home placement and early mortality. Conventional weight loss programs have the potential to reduce body fat, but are difficult to access for older obese adults due to transportation and mobility challenges. The overarching goal of this study is to conduct a program of pilot research aimed at developing and evaluating a technology assisted wellness intervention for older adults with obesity. Study Timeline: September 2018 to April 2021: Goal: Conduct a study of improving weight and physical function in older adults with obesity at home using video-conferencing. An mHealth obesity wellness intervention (MOWI) will integrate a fitness device with a weekly individual dietician-led nutritional session, along with twice weekly physical therapist led group exercise session performed in a person's home. Participation Duration: Three times weekly for 6 months. We shall also have participants return to the center once monthly
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
58
MOWI will be delivered via video-conferencing in the subject's home in a 3x per week, 26-week program from the coordinating center. It will include an individual dietician-led weekly nutrition session; 2x/week physical therapist-led group exercise session; and remote fitness device monitoring. We plan 5 cohorts of 8 subjects (n=40). In-person Research Assistant-led assessments will occur at 0, 8, 16 and 26 weeks. Recruitment, screening, selection criteria, and usability parallel Aim 2 (NCT03104192).
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, United States
Change in Grip Strength
Assessed by a Jamar dynamometer. Sensor-based Thera-bands will measure data on strength change.
Time frame: Change between baseline and follow-up at 26-weeks
Change in 30 Second Sit-to-Stand (STS)
STS measures lower limb strength - change represented as repetitions.
Time frame: Change between baseline and follow-up at 26-weeks
Change in Six-Minute Walk Test (6MWT)
A surrogate for cardiovascular fitness that measures distance (normal 400-700m) related to function. A clinically important difference is 50-55m
Time frame: Change between baseline and follow-up at 26-weeks
Change in Gait Speed (Meters Per Second)
Gait speed is measured by the time it takes to walk 20 meters. Gait speed predicts disability and mortality (a significant change is considered 0.1 meters per second).
Time frame: Change between baseline and follow-up at 26-weeks
Change in Late-Life Function and Disability Instrument (LLFDI)
LLFDI consists of a 32-item function and 16-item disability (life-task) scales that correlate with gait speed and lower limb function. For this instrument we use only the 32-item function and scores are scaled. Minimum 0, Maximum 100. Higher scores indicate higher levels of function
Time frame: Change between baseline and follow-up at 26-weeks
Behavioral Activation (Patient Activation Measure)
Patient Activation Measure (PAM) assesses knowledge, confidence and skill for managing health and grouped into 4 levels revealing insights into attitudes, motivators, behaviors \& outcomes. Score ranges from 0 to 100, higher scores indicate higher activation.
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Time frame: baseline and follow-up at 26-weeks
Subjective Health Status (PROMIS)
Patient Reported Outcomes Measurement Information Systems (PROMIS) Global Short Form. PROMIS is a 10-item instrument capturing physical, mental and social aspects of quality of life having undergone quantitative appraisal and is non-proprietary. A score of 50 indicates the population mean with a standard deviation of 10. Higher scores indicate better health.
Time frame: Change between baseline and follow-up at 26-weeks
Change in Weight in kg
Change in weight in kg
Time frame: Change between baseline and follow-up at 26-weeks
Change in Body Mass Index (BMI) in kg/m^2
Change in body mass index (BMI) in kg/m\^2
Time frame: Change between baseline and follow-up at 26-weeks
Change in Waist Circumference in cm
Change in waist circumference in cm
Time frame: Change between baseline and follow-up at 26-weeks
Steps
Fitibit will assess steps
Time frame: Change between baseline and follow-up at 26-weeks
Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS) -
CHAMPS is a self-reported tool in older adults that assesses activity levels and types. A change in score represents a change in the rates of participants in that specific category. A lower number (mean) represents a decrease in the proportion of individuals, while a positive change indicates an increase in the rate of persons. For caloric input, this continuous measure aligns with changes in calories based on activity type per week.
Time frame: Change between baseline and follow-up at 26-weeks
Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS) - Frequency Per Week
CHAMPS is a self-reported tool in older adults that assesses activity levels and types. A change in score represents a change in the rates of participants in that specific category. A lower number (mean) represents a decrease in the proportion of individuals, while a positive change indicates an increase in the rate of persons. For caloric input, this continuous measure aligns with changes in calories based on activity type per week.
Time frame: Change between baseline and follow-up at 26-weeks
Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS) - Hours Per Week
CHAMPS is a self-reported tool in older adults that assesses activity levels and types. A change in score represents a change in the rates of participants in that specific category. A lower number (mean) represents a decrease in the proportion of individuals, while a positive change indicates an increase in the rate of persons. For caloric input, this continuous measure aligns with changes in calories based on activity type per week.
Time frame: Change between baseline and follow-up at 26-weeks