Jennifer C. Lovejoy - US grants

DESCRIPTION (provided by applicant): Obesity and Type 2 diabetes are emerging epidemics in the U.S. Weight loss improves diabetes outcomes and reduces the need for anti-diabetic medication. However, implementation of behavioral weight loss programs in a primary care setting has proven to be a challenge. Internet-based weight loss programs have been shown to be effective, however, access to personal computers is limited among elderly and low-income populations. Additionally, computers require a degree of technical sophistication and access to the Internet poses a barrier for a significant portion of the at-risk diabetes population. A solution is required that offers the benefits of Internet-based weight loss programs without the technical challenges or cost. The overall goal of this study is to explore the human engineering issues of a home-based telehealth system, Healthium, utilizing an interactive television system over a broadband connection. The telehealth system to be tested support audio and video communications (synchronous or asynchronous), medical reminders, physiological monitoring (e.g. body weight) and diagnostic devices (e.g. glucometers), on screen health status tracking, patient education (audio, text and multimedia), and interactive health surveys. The program will be based on Internet-aided behavioral weight loss programs previously developed by the investigators. The proposed project will demonstrate how a diet and exercise program can be conducted with patients in their home via a television set and using the TV remote control. If the content can be successfully transposed from a PC/Internet environment to an interactive television platform, we would be able to demonstrate a convenient, intuitive and inexpensive way to conduct large-scale interventions related to obesity and nutrition. This could lead to a viable public health care initiative for prevention of obesity-associated chronic diseases. The Specific Aims to be addressed in this proposal are: 1) To transfer a successful Internet-based weight loss program onto the Healthium interactive platform and further develop the intervention for use in patients with Type 2 diabetes. 2) To conduct focus groups to determine consumer acceptance of the convenience and intuitiveness of the Healthium interface. 3) To perform a pilot study in patients with Type 2 diabetes to determine whether the Healthium interface improves weight loss and diabetes outcomes relative to standard clinic-based treatment.

ABSTRACT (Provided by the applicant): Patient utilization of a broad spectrum of Complementary and alternative Medical (CAM) therapies is at the highest level in recent history of this country and continues to increase. However, there is a lack of adequate research providing accurate information to illuminate and validate the efficacy, economy, and safety of CAM therapies. This in turns perpetuates a skepticism about CAM, held by patients, physicians and researchers, which has profound consequences both on the economics and effectiveness of our national health care system. A successful medical system provides patients and physicians with the ability to choose from the largest possible armamentarium of therapeutic and preventative health care regimens that have been proven to be both medically efficacious and cost effective. To continued to move toward such a system, it is vitally important that the panoply of CAM therapeutic regimens be validated scientifically. This will proceed most quickly and efficiently with an interdisciplinary and collaborative research effort carried out by scientists trained both in rigorous research methodology and in CAM. Bastyr University, the nations? leading CAM training institution, has initiated this proposal in order to prepare scientist for careers as research scholars and clinical investigators in the field of CAM. Over a five-year period, this program will train 8 postdoctoral (4 ND, 2 PhD and 2 MD) fellows, each for a period of three years, plus thirty predoctoral students in short term positions. Training opportunities are available from 18 faculty members, representing five preeminent research and educational institutions in Washington State. We have assembled mentors with acknowledged expertise in their fields, with divergent enough backgrounds to provide a breadth of training experiences, and with a common interes in the efficacy of CAM in the treatment of cancer and cancer-related pain. We believe that the combined expertise and commitment of these individuals, in the context of the superlative research environment in Seattle creates a unique opportunity to successfully train scientists who will be able to bring traditional research methods to bear upon CAM related research topics.

[unreadable] DESCRIPTION (provided by applicant): Patient utilization of a broad spectrum of Complementary and Alternative Medical (CAM) therapies is at the highest level in the recent history of this country and continues to increase. However, there is a lack of adequate research providing accurate information to illuminate and validate the efficacy, economy, and safety of CAM therapies. A successful medical system provides patients and physicians with the ability to choose from the largest possible armamentarium of therapeutic and preventative health care regimens that have been proven to be both medically efficacious and cost effective. To continue to move toward such a system, it is vitally important that the panoply of CAM therapeutic regimens be validated scientifically. This will proceed most quickly and efficiently with an interdisciplinary and collaborative research effort carried out by scientists trained both in both rigorous research methodology and in CAM. Bastyr University, the nation's leading CAM training institution, is submitting this competing continuation application to continue our successful postdoctoral and predoctoral training program for scientists who desire careers as research scholars and clinical investigators in the field of CAM. Over the past 3 years, this training program at Bastyr has resulted in the successful development of multi-disciplinary collaborations among researchers and allied health professionals at CAM and allopathic institutions, and has trained 8 postdoctoral fellows and 18 short-term predoctoral trainees in CAM-related research. We currently propose to extend this successful program for another 5 years to train an additional 8 postdoctoral fellows (4 ND, 2 PhD and 2 MD) for three years each, and thirty predoctoral students in short term summer positions. Training opportunities are available from 19 faculty members, representing four preeminent research and educational institutions in Washington state. We have assembled mentors with acknowledged expertise in their fields, with divergent enough backgrounds to provide a breadth of training experiences, and with a common interest in the efficacy of CAM in the treatment of chronic disease, particularly cancer, obesity and Type 2 diabetes. We believe that the combined expertise and commitment of these individuals, in the context of the superlative research environment in Seattle, creates a unique opportunity to successfully train scientists who will be able to bring traditional research methods to bear upon CAM-related research topics. By centering CAM research training at an institution with a mission of training CAM practitioners and researchers and enhancing collaborations with mainstream biomedical research institutions, this application addresses a critical and strategic need of building resources and infrastructure to allow for cutting-edge research on CAM modalities. [unreadable]