Obesity Clinical Trial
Official title:
Program to Improve Care in Complex Chronic Disease
The purpose of this study is to pilot test an mHealth technology-supported behavioral intervention designed to engage patients with diabetes and concurrent chronic kidney disease (CKD) in multiple behaviors which aim to reduce CKD progression. Participants will be randomized to the 6-month lifestyle intervention or to a wait-list control. The lifestyle intervention will be modeled after that used in the Diabetes Prevention Program (DPP) and the counseling intervention will be based on SCT, which will be paired with mobile technology-based dietary and physical activity monitoring. The wait-list control will receive 6 months of standard medical care followed by a delayed, but less intensive, 6-month intervention.
The purpose of this study is to develop and pilot test a lifestyle intervention in obese
individuals with t2dm and concurrent stage 2-4 ckd. The counseling intervention will be based
on social cognitive theory and supported by mobile (ipad) self-monitoring. Mobile
self-monitoring is featured in the intervention to encourage vigilance to the diet in a
manner that is not burdensome, enhance self-efficacy by integrating complex information
regarding the ckd dietary regimen with a calorie-restricted diet, and permit real-time
monitoring of weight, blood glucose, blood pressure, and self-reported diet and physical
activity by the study team.
Specifically, the investigators will develop the methods for and pilot test the ckd lifestyle
intervention in stage 2-4 ckd patients and explore the impact of the intervention on: (a)
weight and fat mass, (b) blood pressure, (c) physical activity, (d) urinary sodium excretion,
(e) serum phosphorus and calcium-phosphorus product, (f) kidney function as measured by serum
cystatin-c, and (g) serum lipids. Additionally, we will evaluate the feasibility and
acceptability of this intervention in terms of: (h) recruitment and retention, (i) time and
cost associated with training ckd patients in technology-based self-monitoring and in
delivering the intervention, (j) patterns of self-monitoring adherence over time, and (k)
participant satisfaction with the intervention. Finally, we will describe: (l) the extent to
which the intervention differentially adversely affects the nutritional health of
participants as evidenced by low serum albumin or serum prealbumin; a body mass index (bmi)
that falls below 20kg/m2; and subjective assessment of nutritional risk (e.g. Nausea,
diarrhea, anorexia).
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