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Rapid Evaluation of Innovative Intervention Components to Maximize the Health Benefits of Behavioral Obesity Treatment Delivered Online: An Application of Multiphase Optimization Strategy

Award Number: R01DK117857
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Rapid Evaluation of Innovative Intervention Components to Maximize the Health Benefits of Behavioral Obesity Treatment Delivered Online: An Application of Multiphase Optimization Strategy - PROJECT SUMMARY/ABSTRACT Decades of research have demonstrated that behavioral obesity treatments can produce clinically significant weight losses that improve health and disease risk/severity. However, these treatments have not been disseminated widely due to high costs and lack of qualified providers. We therefore aimed to develop a fully automated online obesity treatment that would produce clinically significant weight losses (i.e., ≥ 5 % of initial body weight) when delivered online in a variety of settings. Our 3-month program, Rx Weight Loss (RxWL), produced clinically significant mean±SD weight losses of 5.8±4.4 % of initial body in patients referred by physician (N=154), 5.8 ±5.2 % in worksites (N=75), and 4.2±5.3 % in community settings (N=230). These weight losses were largely maintained at 6-month follow-up. Given these positive results, healthcare stakeholders have expressed a desire to pursue dissemination of RxWL. In order to maximize the public health impact of disseminating RxWL and similar programs, and advance the science of online behavioral intervention in general, it is imperative to evaluate innovative behavioral intervention components with the potential to optimize weight loss outcomes. Despite promising mean weight losses, only about half of participants treated online achieve weight losses of > 5%. Furthermore, the health benefits of weight loss are dose dependent; optimizing RxWL to produce larger mean weight losses would therefore enhance its health benefits. Optimizing RxWL would also provide a template for optimizing other online treatments. Because digital health technology evolves rapidly, we will use the Multiphase Optimization Strategy (MOST) framework to most quickly and efficiently determine which, if any, of 5 innovative intervention components, alone or in combination, increases the proportion of patients achieving a ≥5% weight loss, and mean weight loss, of the RxWL program at 12- months. The 5 intervention components to be tested are: (a) Web-based virtual reality intervention for training in basic behavioral weight loss skills; tailored interactive intervention targeting (b) structured physical activity and (c) dysregulated eating; (d) a platform for social interaction including opportunities for friendly competition, and (e) interactive video feedback with content tailored to the unique needs of each participant and a focus on dietary skills. After initial testing with N=32 to refine and finalize the intervention components with feedback from advisory boards, N=384 individuals with BMI ≥ 25 will be randomized to receive RxWL and 0-5 of the experimental intervention components in a full factorial experiment. This design will allow us to determine which intervention components maximize weight loss and whether there are favorable combinations of components. In addition, by evaluating the effects of each component on proximal outcomes (i.e., mediators) we will learn not only which components are (or are not) effective but also why or how they exert their effects. This project advances the science of behavioral obesity treatment, and will directly impact the care of patients receiving RxWL.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$52 )
2025	2022	THE MIRIAM HOSPITAL	164 SUMMIT AVE	PROVIDENCE	RI	02906	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	5/6/2025	NON-COMPETING CONTINUATION	-$52
														Subtotal = -$52

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2022	THE MIRIAM HOSPITAL	164 SUMMIT AVE	PROVIDENCE	RI	02906	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	3/27/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $580,929 )
2022	2022	THE MIRIAM HOSPITAL	164 SUMMIT AVE	PROVIDENCE	RI	02906	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	3/29/2022	NON-COMPETING CONTINUATION	$580,929
														Subtotal = $580,929

Issue Date FY: 2021 ( Subtotal = $595,821 )
2021	2021	THE MIRIAM HOSPITAL	164 SUMMIT AVE	PROVIDENCE	RI	02906	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	3/26/2021	NON-COMPETING CONTINUATION	$595,821
														Subtotal = $595,821

Issue Date FY: 2020 ( Subtotal = $592,164 )
2020	2020	THE MIRIAM HOSPITAL	164 SUMMIT AVE	PROVIDENCE	RI	02906	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	3/16/2020	NON-COMPETING CONTINUATION	$592,164
														Subtotal = $592,164

Issue Date FY: 2019 ( Subtotal = $641,666 )
2019	2019	THE MIRIAM HOSPITAL	164 SUMMIT AVE	PROVIDENCE	RI	02906	PROVIDENCE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	5/20/2019	NEW	$641,666
														Subtotal = $641,666

Grand Total All Awards = $2,410,528

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Rapid Evaluation of Innovative Intervention Components to Maximize the Health Benefits of Behavioral Obesity Treatment Delivered Online: An Application of Multiphase Optimization Strategy

Award Number: R01DK117857

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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