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BACKGROUND/RATIONALE:
Overweight and obesity are significant public health concerns associated with increased morbidity and mortality. Prevalence rates of overweight and obesity among adults in the United States have grown markedly during the last decade with current rates estimated at 66.3% for overweight and 32.2% for obesity. Rates of obesity within the VHA are estimated to be higher than these national figures. Physical activity and weight loss can reduce the risk and negative effects associated with overweight and obesity. The VA MOVE! (Managing Overweight and Obesity for Veterans Everywhere) program is a nationwide initiative to promote healthy living, exercise, and weight reduction in overweight and obese veterans. Currently, MOVE! groups for patients provide education on the health benefits of regular exercise as well as strategies to increase activity level. However, beyond this basic education, participants receive no additional structure or formalized programming to assist them in their efforts to develop a more active, healthy lifestyle. Consequently, the vast majority of MOVE! group members at the VA Boston Healthcare System have remained sedentary.
OBJECTIVE(S):
The aim of this project is to develop and evaluate the feasibility of a practical exercise program that incorporates interventions that have been shown to facilitate the adoption of physical activity. These interventions include: 1) increasing exercise confidence and self-efficacy; 2) developing specific and individualized goals for each patient; 3) incorporating social support; 4) utilizing small, inexpensive incentives (e.g., evaluation of community-based walk programs revealed that the distribution of materials such as water bottles, shirts, and umbrellas served as powerful motivators to increase activity level), and 5) incorporating pedometers. A secondary objective of the proposed project is to conduct exploratory analyses of the influence of the intervention on exercise attitudes and behavior, physical and psychological health-related parameters, quality of life, and treatment adherence.
METHODS:
Fifty overweight or obese participants will be randomized to one of 2 conditions: a walking group condition (the "Walk-A-Weigh" program) or a comparison group. The walking group will also participate in structured walking groups and receive small motivational incentives. Both will receive an initial assessment, a walking exercise prescription, and a post-intervention assessment.
Participants must have a Body Mass Index of at least 25 kg/m2 and express an interest in increasing their participation in physical activity. In addition, all participants must obtain a medical clearance from a physician to participate in a walking program. We will exclude participants who have orthopedic problems precluding participation in a walking program. Participants also will be excluded if they report active psychosis, substance abuse or psychiatric hospitalizations in the last 6 months, or are unable to understand conversational English. Subjects will then be randomized into either the intervention group which includes structured walking groups and motivational incentives or to a comparison group that does not partake in the proposed walking program. All participants will complete an assessment at baseline, record their physical activity over an 8-week period, and then complete another post-assessment at the conclusion of the study.
For participants in the walking group condition, a range of walking groups (e.g., shorter, longer, and indoor walks, etc) that take place near the Jamaica Plain VA campus will be established to enhance social support and meet the individualized needs of the patients. In addition, these groups will help participants to translate their laboratory exercise prescription into regular practice in their everyday lives. Participants will be encouraged to participate at least weekly during weeks 2-8. An exercise physiologist will lead these groups, which will allow for the exchange of practical tips while actually exercising. The exercise physiologist will also be able to use time before and after these sessions to individually review participants' goals, and provide feedback as necessary. Participants will be provided with small incentives to increase the likelihood that they will exercise (e.g., water bottles, t-shirts, etc.).
FINDINGS/RESULTS:
There are no findings to report to date.
IMPACT:
The project is poised to address overweight and obesity, both major health problems within our veteran population, through the adoption of physical activity. Increasing physical activity to enhance weight loss efforts has significant and positive implications for veterans' long-term mental and physical health.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases
DRE:
Treatment, Prevention
Keywords:
Obesity
MeSH Terms:
none
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