Texting for Mobility in Overweight/Obese Adults with Peripheral Artery Disease

University Of New Mexico Health Scis Ctr, Albuquerque NM

Investigators

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Abstract

Project Summary/Abstract Peripheral artery disease (PAD) is a prevalent illness that affects 12% of U.S adults. The prevalence by race/ethnicity is 22% for African Americans, 13.2% for non-Hispanic Whites, and 13.7% for Latinos. PAD has a profound impact on walking ability including a reduction in walking distance, speed, and stair climbing. Physical inactivity, poor dietary habits and obesity, common among U.S. adults, are significant risk factors for progression of PAD and its adverse outcomes. Prior trials have demonstrated the efficacy of walking therapy to improve function in patients with PAD. Currently, there is a gap in the literature regarding the additive benefit of a dietary intervention with walking therapy to further improve functional outcomes in patients with PAD. To date, the delivery of successful walking therapy interventions has been largely through face-to-face and/or telephone counseling. Widespread uptake of walking interventions has been hampered by the staff- intensity and expense of these interventions. Text messaging avoids this limitation by offering an accessible platform available to most Americans. Text messaging permeates all ages, cultures, and socioeconomic backgrounds. The percent of middle-age to older adults who utilize text messaging ranges from 68% to 83%, making the delivery of behavior change interventions using text messaging a viable option for overweight/obese adults with PAD. The overall objective of this application is to determine the efficacy of a multicomponent, bilingual community-based intervention to promote weight loss and improve walking distance in overweight/obese adults with PAD. We propose to combine the PACE program with a dietary intervention adapted from that used in the successful NIH-funded Look AHEAD trial. This combined dietary (D) and physical activity intervention (PACE) will be delivered using text messaging combined with brief telephone calls - (PACE+Dtext). We will assess the efficacy of PACE+Dtext to promote weight loss in overweight/obese adults, from 3 ethnic groups (African American, Latino [English or Spanish speaking], and non-Hispanic white). This will be the first trial to utilize text messaging to improve outcomes for a racially diverse, high risk population with PAD. We will randomize (n=204) overweight/obese adults with PAD to one of three arms: Tx3: PACE+Dtext; Tx2: PACEtext alone; orTx1: Attention Control (general health and wellness). The dose for the interventions and attention control will be 2 text messages daily, 5 days per week, combined with brief telephone calls, biweekly for 3 months followed by monthly for 3 months. Intervention efficacy at 6- and 12 months will be evaluated for a diverse set of outcomes, including the primary outcome of weight loss and secondary outcomes including walking distance and quality of life.