1. High-intensity Treatment & Weight Reduction Goal Achievement with MOVE
Jane T. Garvin, PhD, RN, FNP-BC
College of Nursing, Georgia Regents University, Augusta, Georgia
INTRODUCTION
RESULTS
DISCUSSION
The Obesity Society’s 2013 guideline1 identified
5% weight reduction as the initial weight reduction goal and
high-intensity ( > 14 sessions in 6 months) interventions as the most effective behavioral treatment for obesity and comorbid conditions with a BMI > 27
MOVE!®
The Veteran’s Administration clinical facilities’ behavioral weight reduction program 2,3
Free of charge to veterans 4
Outcomes varied by age, gender, race and participation 5-9
MOVE!® program outcomes have not been evaluated in terms of weight reduction and engaging participants to achieve a high-intensity intervention at 6 months.
Table 1. Baseline Characteristics (n = 216)
Findings are consistent with earlier reports that more weight reduction was associated with attending more sessions
Findings support guideline recommendation for 14 or more sessions within six months
MOVE!® design was a limitation
Not designed to have 14 sessions
Not designed for 6 month data
Clinical Implication - educating providers and potential participants about the benefit of attending 14 or more sessions within six months of enrollment
Further study needed - especially related to participants who achieved 5% weight reduction at six months but failed to achieve high-intensity MOVE!®
Demographics
Mean ± SD
Frequency (%)
Age (Range 26 – 81 years)
57.5 ± 10.9
Male
174 (81)
African American
125 (58)
Obesity
Body Mass Index (Range 27 – 62.7)
35.3 ± 6.2
Comorbidity
Diabetes
71 (33)
Hypertension
152 (70)
Hyperlipidemia/Dyslipidemia
128 (59)
CONCLUSIONS
Participants who achieved high-intensity MOVE!® were five times more likely to meet the weight reduction goal of at least 5% at six months than those participants who attended fewer sessions.
Table 2. MOVE!® Participation during first 6 months (n = 216)
Sessions
Range
Mean ± SD
Frequency (%)
Number
0-24
High Intensity ( > 14)
11 (5)
PURPOSE
REFERENCES
The purpose of this study was to examine weight reduction and high-intensity treatment at 6 months after enrolling in the local MOVE!® program.
Jensen MD, Ryan DH, Donato KA, Apovian C M, et al. (2014) Guidelines (2013) for the management of overweight and obesity in adults. Obesity, 22(S2), S1-S410.
Kinsinger LS, Jones KR, Kahwati L, Harvey R, et al. (2009) Design and dissemination of the MOVE! weight-management program for veterans. Preventing Chronic Disease, 6(3), A98.
Veterans Health Administration. (2006) Managing Overweight and/or Obesity for Veterans Everywhere (MOVE!) program (VHA Handbook ). Washington, D.C.: Department of Veterans Affairs,
Department of Veterans Affairs. (April 16, 2008). Elimination of Co-Payment for Weight Management Counseling, 73 Fed. Reg. 20,530.
Dahn JR, Fitzpatrick SL, Llabre MM, Apterbach GS, Helms RL, et al. (2011) Weight management for veterans: Examining change in weight before and after MOVE! Obesity, 19(5),
Jay, M. (2011). Outcomes research in review. Impact of VA weight management program for veterans. Journal of Clinical Outcomes Management, 18(7),
Romanova M, Liang LJ, Deng ML, Li Z, Heber D. (2013) Effectiveness of the MOVE! Multidisciplinary weight loss program for veterans in Los Angeles. Preventing Chronic Disease, 10, E112.
Littman AJ, Boyko EJ, McDonell MB, Fihn SD. (2012) Evaluation of a weight management program for veterans. Preventing Chronic Disease, 9, E99.
Garvin JT, Marion LN, Narsavage GL, Finnegan L. (2015) Characteristics influencing weight reduction among veterans in the MOVE!® program. Western Journal of Nursing Research. 37(1),
Table 3. Weight Reduction at 6 months (n = 216)
Weight Reduction
Frequency (%)
Goal Achieved with > 5% Weight Reduction
34 (16)
METHODS
Data were extracted from medical records of local MOVE!® program group participants for this descriptive study.
Key measures
Weight reduction
weights at baseline
6 months post-enrolling
Participation in group MOVE!® over 6 months
number of sessions
14 or more sessions
Descriptive statistics
Logistic regression
Used to examine the effect of high-intensity MOVE!® on achievement of 5% or greater weight reduction six months post-enrollment while controlling for age, gender, and race
Table 4. Logistic Regression Models for 5% Weight Reduction at 6 months
Variable b OR p
95% CI
Age
.004
1.04
.85
.97, 1.04
Female
-.76
.47
.26
0.12, 1.77
African American
-.36
.70
.37
0.32, 1.52
High-intensity MOVE! ®
1.56
4.74
<.02*
1.31, 17.16
ACKNOWLEDGEMENTS
Katherine Maeve, PhD, RN, Nurse Researcher & VA Postdoctoral Nursing Fellowship Program Director; and Lucy Marion, PhD, FAAN, Program Mentor
Karen Cota, RD, LD, CDE, CNVAMC MOVE!® Program Coordinator
Caroline McKinnon, PhD, CNS/PMH-BC, assisted with data collection
Stephen Looney, PhD, provided statistical consultation
The Department of Veterans Affairs funded this work with a Postdoctoral Nursing Fellowship.
Additional funding provided by Georgia Regents University College of Nursing and Beta Omicron Chapter of Sigma Theta Tau International
Variable b OR p
95% CI
High-intensity MOVE! ®
1.62
5.06
.01*
1.45, 17.65
* p < .05
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