Obese adults struggle to make the changes necessary to achieve even modest weight loss, though a decrease in weight by as little as 10% can have significant health benefits. Failure to meet weight ...loss goals may in part be associated with barriers to obesity treatment. Wide-spread dissemination of evidence-based obesity treatment faces multiple challenges including cost, access, and implementing the programmatic characteristics on a large scale.
The PDA+: A Personal Digital Assistant for Obesity Treatment randomized controlled trial (RCT) was designed to test whether a PDA-based behavioral intervention enhances the effectiveness of the existing group weight loss treatment program at VA Medical Centers Managing Overweight/Obese Veterans Everywhere (MOVE!). We also aim to introduce technology as a way to overcome systemic barriers of traditional obesity treatment.
Veterans enrolled in the MOVE! group at the Hines Hospital VAMC with BMI ≥ 25 and ≤ 40 and weigh < 400 pounds, experience chronic pain (≥ 4 on the NRS-I scale for ≥ 6 months prior to enrollment) and are able to participate in a moderate intensity exercise program will be recruited and screened for eligibility. Participants will be randomized to receive either: a) MOVE! treatment alone (Standard Care) or b) Standard Care plus PDA (PDA+). Those randomized to PDA+ will record dietary intake, physical activity, and weight on the PDA. In addition, they will also record mood and pain intensity, and receive biweekly telephone support for the first 6-months of the 12-month study. All participants will attend in-person lab sessions every three months to complete questionnaires and for the collection of anthropomorphic data. Weight loss and decrease in pain level intensity are the primary outcomes.
The PDA+ trial represents an important step in understanding ways to improve the use of technology in obesity treatment. The trial will address barriers to obesity care by implementing effective behavioral components of a weight loss intervention and delivering high intensity, low cost obesity treatment. This RCT also tests an intervention approach supported by handheld technology in a population traditionally considered to have lower levels of technology literacy.
ClinicalTrials.gov: NCT00371462.
To evaluate a student-generated question assignment in a pharmacotherapy course for (1) perceived educational value, (2) faculty and student satisfaction, (3) item quality, (4) workload, and (5) ...perceived benefit.
Second-year pharmacy students in a dual campus college participated in generating patient-based vignettes with associated multiple-choice questions for an exam. Submissions were assessed by faculty in terms of structure and content and then made available to all students as a study aid. Project evaluation included examination of item quality as well as faculty and student surveys exploring educational value, general satisfaction with the assignment, and workload.
Post-project satisfaction surveys were completed by 97% of students (n = 165) and 100% of faculty (n = 8). Overall, 80% of students agreed or strongly agreed that they were proud of their group’s final submission, and more than 85% agreed or strongly agreed that participation in the project assisted them in analyzing concepts and guidelines taught in class. All faculty members agreed or strongly agreed that the activity should be conducted in future offerings of the course. The average point biserial correlation coefficient for the student-generated items was 0.26 versus 0.22 for faculty-written items. Structure- and content-focused faculty spent an average of 27 minutes (SD 6) and 52 minutes (SD 14), respectively, to complete each assignment.
A student-generated question assignment can be feasibly conducted across two campuses as an active learning exercise that enhances student-perceived learning of pharmacotherapy principles with a high level of both student and faculty satisfaction.
A benefit of using nature-based solutions in cities is that they often provide multiple co-benefits in addition to helping solve the original “problem.” For example, a new urban park can provide not ...only more equitable access to outdoor recreational opportunities, but also it can help cool the surrounding neighborhood, provide flood protection, mitigate climate change, and improve the mental and physical health of those with access to it. Mapping, measuring, and valuing the benefits provided by nature-based solutions can provide useful information to municipal leaders as they weigh options. In this chapter, we introduce the theory and practice of valuation - in both monetary and non-monetary terms - of nature-based solutions in cities. We detail examples of using practical approaches and tools in China and the United States and close by highlighting barriers and opportunities to (re)designing equitable, livable, sustainable cities.
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