2017 HSR&D/QUERI National Conference

2004 — Improving the Reach and Impact of Behavioral Treatment for Obesity: To Tailor or Not to Tailor

Lead/Presenter: Laura Damschroder, COIN - Ann Arbor
All Authors: Damschroder LJ (Ann Arbor Center for Clinical Management Research (CCMR)) Raffa S (VHA National Center for Health Promotion and Disease Prevention) Cohen AN (VA HSR&D Center for Healthcare Innovation, Implementation and Policy) Moin T (VA HSR&D Center for Healthcare Innovation, Implementation and Policy)

Brief description of panelists:
The panelists are committed to improving the reach and impact of behavioral interventions for obesity in order to lessen premature mortality and healthcare costs. Dr. Susan Raffa is VHA's National Program Director for Weight Management and is instrumental in developing guidance for implementation of MOVE!(TM) Weight Management Program for Veterans.. Dr. Amy Cohen will present data supporting the development, implementation, and impact of a tailored MOVE! program for Veterans with serious mental illness; Dr. Tannaz Moin will present data supporting the implementation and impact of a tailored weight management program to prevent diabetes in female Veterans; Ms. Laura Damschroder will moderate this panel and brings in-depth experience with multiple weight management programs including MOVE! and implementation of such programs.

Description of the question or issue that will be discussed:
Behavioral treatment for obesity, MOVE!, has been implemented VA-wide but certain populations may require more tailored support in order to engage, utilize, and benefit from the treatment. The ongoing argument, which will be discussed in this panel, is whether there is advantage to the organization and/or the Veteran population for further tailoring in the context of an existing disseminated treatment program, MOVE!. The panel will provide evidence for, against, and under what circumstances to consider tailoring and generate provocative discussion with participants. This challenging question also applies widely to interventions other than MOVE! that have been disseminated and maintained at high cost to the organization but may not be utilized at a high rate, often resulting in muted impact on Veteran outcomes.

Significance—Description of why the issue is important for Veterans, VA, and the audience:
Overweight/obesity is highly prevalent among Veterans and contributes to premature death from obesity-related illness such as diabetes and cardiovascular disease. Although MOVE! has been disseminated in VA, it is underutilized and may need to be tailored in order to improve reach and outcomes. Understanding when tailoring is or is not valuable and for which specific subpopulations is essential to inform policy-making, decisions about whether to scale-up and spread, and guidance for frontline implementations, all of which are aimed at having greatest impact on Veteran health and well-being.