An RCT of Nurse Coaching vs Herbal CAM for Soldier Weight Reduction
Name: Mary McCarthy
Rank: MAJ (Ret)
Organization: The Geneva Foundation
Performance Site: Madigan Army Medical Center, Fort Lewis, WA
Year Published: 2012
An innovative approach to Warfighter medical readiness and wellness through weight management is urgently needed. The average body weight of U.S. adults has increased dramatically over the past 3 decades creating a public health crisis with long-term implications for disease and economic burden. Nearly two-thirds of adults, including military service members, are now ov erweight with a body mass index at or above 25. Today's Army Soldier is not exempt from the influences of poor diet choices, less physical activity, genetics, and environmental issues. This prospective, double-blind, randomized, placebo-controlled trial will augment the current Army weight control efforts that incorporate the VA MOVE! curriculum. Specific aims of this study are to evaluate the impact of a nurse health coaching (NHC) intervention delivered by phone or email weekly for reinforcement of weight loss strategies, and to evaluate effectiveness of an herbal weight loss supplement (Garcinia cambogia) over a 12-week interval. In addition, we will use the Self-Motivation Inventory to describe the influence of motivation on adherence to weight loss goals.The primary outcome is weight loss and secondary outcomes are body fat, waist circumference, resting energy expenditure, lipid metabolism, bone mineral density (BMD), and adherence. Outcome measures will be obtained at three time points, baseline, week 6, and week 12, except BMD obtained at baseline and week 12 only. Over a period of 24 months, we will enroll 400 Soldiers,100 in each of 4 groups: 1) MOVE! control group, 2) MOVE! + NHC, 3) MOVE! + NHC+Garcinia cambogia, and 4) MOVE! + NHC+placebo. Repeated measures ANOVA will be used to evaluate group differences in outcome measures over time. Nurses are experts at partnering with clients who are motivated for self-management of weight loss and Soldiers are highly disciplined and dedicated to fulfilling their military oath.The proposed study is novel in that the nurse health coaching intervention and the use of an herbal supplement have not been tested together, or in the military population. This study addresses research priorities related to Force Health Protection, and Health Promotion and Wellness, identified by TSNRP, the Army Surgeon General, and the Army Nurse Corps.