MOWI Home-Based Pilot

June 9, 2023 updated by: John A. Batsis, MD, Dartmouth-Hitchcock Medical Center

Mobile Health Obesity Wellness Intervention in Rural Older Adults (MOWI): Home-Based Pilot

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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

Enrollment (Actual)

58

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New Hampshire
      • Lebanon, New Hampshire, United States, 03766
        • Dartmouth-Hitchcock Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

65 years and older (Older Adult)

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age ≥65 years
  • Body Mass Index (BMI) ≥ 30kg/m^2 OR Waist circumference ≥88cm in females or ≥102cm in males
  • Have Wi-Fi high speed internet
  • Able to obtain medical clearance from doctor
  • Have less than a 5% weight loss in past 6 months
  • No advanced co-morbidity
  • No exercise restrictions
  • Not involved in other research studies that may interfere with participation

Exclusion Criteria:

  • Severe mental or life-threatening illness
  • Dementia
  • Substance use
  • History of bariatric surgery
  • Suicidal ideation
  • Unable to perform measures
  • Reside in nursing home
  • No advanced co-morbidity
  • No exercise restrictions
  • Not involved in other research studies that may interfere with participation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Evaluate home-based MOWI
Conduct and assess the feasibility, acceptability, and potential effectiveness of home-based MOWI in improving physical function.
Behavioral: Evaluate home-based MOWI
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).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Grip Strength
Time Frame: Change between baseline and follow-up at 26-weeks
Assessed by a Jamar dynamometer. Sensor-based Thera-bands will measure data on strength change.
Change between baseline and follow-up at 26-weeks
Change in 30 Second Sit-to-Stand (STS)
Time Frame: Change between baseline and follow-up at 26-weeks
STS measures lower limb strength - change represented as repetitions.
Change between baseline and follow-up at 26-weeks
Change in Six-Minute Walk Test (6MWT)
Time Frame: Change between baseline and follow-up at 26-weeks
A surrogate for cardiovascular fitness that measures distance (normal 400-700m) related to function. A clinically important difference is 50-55m
Change between baseline and follow-up at 26-weeks
Change in Gait Speed (Meters Per Second)
Time Frame: Change between baseline and follow-up at 26-weeks
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).
Change between baseline and follow-up at 26-weeks
Change in Late-Life Function and Disability Instrument (LLFDI)
Time Frame: Change between baseline and follow-up at 26-weeks
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
Change between baseline and follow-up at 26-weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Weight in kg
Time Frame: Change between baseline and follow-up at 26-weeks
Change in weight in kg
Change between baseline and follow-up at 26-weeks
Change in Body Mass Index (BMI) in kg/m^2
Time Frame: Change between baseline and follow-up at 26-weeks
Change in body mass index (BMI) in kg/m^2
Change between baseline and follow-up at 26-weeks
Change in Waist Circumference in cm
Time Frame: Change between baseline and follow-up at 26-weeks
Change in waist circumference in cm
Change between baseline and follow-up at 26-weeks
Steps
Time Frame: Change between baseline and follow-up at 26-weeks
Fitibit will assess steps
Change between baseline and follow-up at 26-weeks
Behavioral Activation (Patient Activation Measure)
Time Frame: baseline and follow-up at 26-weeks
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.
baseline and follow-up at 26-weeks
Subjective Health Status (PROMIS)
Time Frame: Change between baseline and follow-up at 26-weeks
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.
Change between baseline and follow-up at 26-weeks
Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS) -
Time Frame: Change between baseline and follow-up at 26-weeks
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.
Change between baseline and follow-up at 26-weeks
Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS) - Frequency Per Week
Time Frame: Change between baseline and follow-up at 26-weeks
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.
Change between baseline and follow-up at 26-weeks
Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire (CHAMPS) - Hours Per Week
Time Frame: Change between baseline and follow-up at 26-weeks
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.
Change between baseline and follow-up at 26-weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Dartmouth-Hitchcock Medical Center

Collaborators

National Institute on Aging (NIA)

Investigators

  • Principal Investigator: John A Batsis, MD, Dartmouth-Hitchcock Medical Center / Dartmouth Medical School

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 1, 2018

Primary Completion (Actual)

July 1, 2020

Study Completion (Actual)

July 31, 2021

Study Registration Dates

First Submitted

April 3, 2017

First Submitted That Met QC Criteria

April 3, 2017

First Posted (Actual)

April 7, 2017

Study Record Updates

Last Update Posted (Actual)

June 12, 2023

Last Update Submitted That Met QC Criteria

June 9, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • D16182_3
  • K23AG051681 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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