Advance-CTR Mentored Research Awards (2017)
"Randomized Controlled Trial of a Tailored Behavioral eHealth/mHealth Weight Loss Intervention for Cardiac Rehabilitation Patients"
Cardiovascular disease (CVD) is the leading cause of death in the United States and in Rhode Island. Cardiac rehabilitation (CR) is an evidence-based, cost-effective, and widely-available multidisciplinary program that combines supervised exercise with psychoeducation on health behavior change aimed at improving overall health and reducing cardiovascular risk in individuals with CVD. Despite CR’s attention to increasing physical activity and improving diet it produces almost no weight loss. Weight loss would significantly improve the health of CR patients, the majority of whom present to CR with obesity. Gold standard behavioral weight loss interventions (BWLs) delivered in-person produce clinically significant weight loss that improves health and disease risk/severity, but these programs are too burdensome and costly to conduct within CR programs. The primary mentor’s fully automated 3-month online program, Rx Weight Loss (RxWL), produced clinically significant mean±SD weight loss of 5.8±4.4% of initial body weight in physician-referred patients (N=154), 5.8 ±5.2% in worksites (N=75), and 4.2±5.3% in community settings (N=230); this was maintained at 6-months. Dr. Goldstein (candidate) will conduct formative work to tailor RxWL for use in CR. She will then conduct a randomized controlled trial with 88 patients; half will be randomized to receive the tailored intervention, and half will receive an attention-matched online education control. By the 6-month follow-up, the candidate will determine whether this tailored weight loss intervention was effective in this population as determined by a primary outcome of % weight loss at 6-months. Additionally, the candidate will collect data on any further tailoring that may be necessary as well as data on integration into the established CR program; altogether this research will result in a fully-automated BWL treatment package optimized for CR, which will be submitted for testing in a randomized controlled trial in an R01 developed during the grant period. Given the candidate’s success during the course of earning her PhD from Kent State University and completing an NHLBI-funded Cardiovascular Behavioral Medicine T32 at Alpert Medical School of Brown University, the candidate will develop into a successful, independent clinical and translational research scientist. Through a robust training plan and innovative research project, Dr. Goldstein will become one of the only independent scientists to use eHealth/mHealth technology to facilitate WL in CVD, specifically CR, patients.