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RRP 07-332 – HSR&D Study

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RRP 07-332
Promoting Physical Activity in Overweight and Obese Veterans
Allison E. Collins PhD
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Boston, MA
Funding Period: June 2008 - September 2009

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 at the VA Boston, Jamaica Plain campus 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.

OBJECTIVE(S):
The aim of this project was 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 was 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:
The study used a single group, pre-test/post-test design. Participants were 32 overweight or obese adult men and women (BMI of 25 kg/m2 or greater), age 18 or older, who were interested in enrolling in a 7-week walking program. Medical clearance from primary care physicians was obtained prior to participation in the walking program. In addition to the 7-week walking intervention that consisted of structured walking groups and motivational incentives, participants received an initial assessment, a walking exercise prescription, and a post-intervention assessment.

A range of walking groups (e.g., shorter, longer, and indoor walks, etc) took place near the Jamaica Plain VA campus. Groups were led by an exercise physiologist and other study staff, which allowed for the exchange of practical tips while actually exercising. Participants were provided with small incentives throughout their participation in the program as well as sophisticated pedometers that track and record physical activity over a week-long period.

FINDINGS/RESULTS:
Twenty-two participants completed the protocol in its entirety. Participants reported very high levels of satisfaction with the walking program. The mean satisfaction level was 1.43, with a score range of 1 to 5 and lower scores indicating greater satisfaction.

Paired samples t-tests were conducted to evaluate any pre- to post-intervention differences in those who completed the 7 week walking intervention (n = 22). There were no pre to post- differences in weight, body mass index, blood pressure, resting heart rate, body composition, or waist/hip circumference. There were no significant differences in pedometer step counts, amount of physical activity, quality of life or mental health from pre- to post-intervention.

IMPACT:
The project sought to address overweight and obesity in veterans through the adoption of physical activity. Identification of how to most effectively enhance exercise behaviors in veterans has important consequences for veterans' long-term mental and physical health. Study results also have important implications for exercise program design and implementation.

PUBLICATIONS:
None at this time.


DRA: none
DRE: Treatment - Observational, Prevention
Keywords: Obesity
MeSH Terms: none

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