Becca Krukowski, PhD, Receives National Grant for Research in Rural Health Disparities in the Treatment of Obesity and Related Chronic Diseases

Rebecca Krukowski

Rebecca Krukowski, Ph.D.

Rebecca Krukowski, PhD, professor of Public Health Sciences at the University of Virginia, School of Medicine, and her team have received $3.37 million over five years for a grant to determine how to optimize digital obesity treatment for rural populations and address the obesity epidemic. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health sponsored the grant. Dr. Krukowski is Co-Principal Investigator with Professor Delia West, PhD at the University of South Carolina’s Arnold School of Public Health. Also on the grant team are Wen You, PhD, professor of Public Health Sciences at UVA, and from South Carolina, Associate Professor Christine Pellegrini, PhD.

“My research primarily focuses on using technology to increase access to evidence-based behavioral interventions for adults. I have a particular focus on behavioral weight management interventions, self-monitoring behaviors, health equity, and increasing access to rural communities,” explained Dr. Krukowski.

This new study is entitled, “Addressing Rural Health Disparities by Optimizing ‘High Touch’ Intervention Components in Digital Obesity Treatment”. Currently over 130 million individuals in the US have overweight or obesity, and rural communities experience significantly higher rates of obesity and related chronic diseases. However, Dr. Krukowski said, “Weight loss of as little as 5-7% can reduce obesity-associated co-morbidities. Although lifestyle interventions successfully produce weight loss of this magnitude, access to weight management programs is limited in rural areas. This study will examine how digital interventions can be optimized for delivering weight loss programs to rural populations.”

Dr. Krukowski added, “Research has found that in-person behavioral obesity treatment programs achieve better weight loss than digital programs. However, some studies indicate that having a human ‘behind the curtain’ of a digital program, through emailed feedback or with the addition of online group sessions, can significantly increase weight loss. The aims of this study are to increase the public health impact of digital obesity treatment for rural populations by simultaneously investigating and comparing three ‘high touch’ intervention components.”

This study will recruit during a three-year period starting in the summer of 2023 and enroll 616 participants including both men and women in non-urban areas. Based on their randomization assignment, the participants may receive three “high touch” intervention components: (1) weekly facilitated synchronous group video sessions; (2) type of self-monitoring feedback received (detailed vs. focused); and (3) individual coaching calls. However, all participants will receive the core online weight loss program over 6 months.

Based on the results of the experiment, the team will identify an optimized program in which each component (or combination of components) contributes meaningfully to enhanced weight loss. They will also investigate potential mechanisms for these weight loss outcomes, such as accountability, social support, self-regulation, motivation, and problem solving. The team will also examine how the ideal intervention package may differ based on sex, race/ethnicity, and age. Costs of treatment delivery is another area the team will examine for each component, as well as weight maintenance for participants at 6-months post treatment.

Ultimately, this research will provide a basis for the best digital behavioral weight loss intervention that will be more accessible to rural populations than traditional in-person programs. This research will provide evidence for intervention packages for rural residents to reduce obesity and provide essential evidence to inform public health policy decisions, such as a potential coverage for digital weight loss programs by Medicare and Medicaid. Congratulations on this award to conduct such beneficial research, Dr. Krukowski!

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