R01CA268034

Rural Engagement in TelemedTeam for Options in Obesity Treatment Solutions (RE-TOOL) - Project Summary/Abstract

Obesity increases the risk for 13 types of cancer and now affects over 40% of the U.S. adult population, with even higher prevalence among rural Americans. Most worrisome, the prevalence of Class 3 obesity (BMI = 40), which contributes the highest cancer risk, is increasing at a rate 3 times higher in rural communities compared to urban areas.

Rural residents often lack access to weight control programs and food and physical activity resources that promote healthy lifestyles, especially in small or remote rural areas. It is paramount that obesity treatment be offered in rural primary care, especially to reach those who have Class 3 obesity and/or co-morbid medical conditions who carry the highest obesity-related cancer risk.

Medical management by a primary care provider (PCP) during behavioral weight loss is essential to address co-morbid medical conditions, evaluate obesogenic medications, and explore options for guideline-recommended pharmacotherapy and surgical treatment. However, there has been a missed opportunity in primary care-based obesity treatment trials for capitalizing on guideline-based medical management.

The current trial builds on lessons learned in our recently completed RE-POWER trial conducted in rural primary care clinics, which demonstrated significantly greater weight loss with in-clinic group visits versus individual visits, and highlighted the need for medical management by the local PCPs.

RE-TOOL (Rural Engagement in TelemedTeam for Options in Obesity Treatment Solutions) is a cluster RCT (N = 16 clinics and 560 participants) designed to enhance sustainable access to obesity treatment in rural communities. TelemedTeam is a novel team-based telemedicine approach that pairs intensive telemedicine group visits with quarterly individual team-based clinic visits that simultaneously engage the patient, the local PCP, and the lifestyle coach to help activate the patient.

This novel collaborative telemedicine solution combines the benefits of group-based treatment with home-based telemedicine delivery, and critically, integrates team-based care in local rural clinics to capitalize on the importance of medical management and access to local support and resources.

The primary hypothesis is that TelemedTeam will result in greater % weight loss at 24 months compared to enhanced usual care consisting of quarterly PCP visits only. Secondary outcomes include the proportion achieving =5% and 10% weight loss, diet quality, physical activity, quality of life, and medical treatment process outcomes.

Exploratory analyses will assess reach, adoption, and implementation and investigate rural sociocultural and spatial predictors of treatment effects.

University Of Kansas Medical Center Research Institute

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Kansas City, Kansas 66160 United States

Single Zip Code

Administrative Supplements to Existing NIH Grants and Cooperative Agreements (Parent Admin Supp Clinical Trial Optional) (PA-20-272)

Amendment Since initial award the total obligations have increased 354% from $800,262 to $3,634,974.