# Pragmatic Obstructive Sleep Apnea Weight Loss Trial Assessing Effectiveness and Reach (POWER)

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2021 · —

## Abstract

Background: Prevalent obesity related conditions like obstructive sleep apnea (OSA) represent an important
opportunity for the VA to improve population health. OSA markedly reduces quality of life and is associated
with 3-fold greater risk for cardiovascular disease. Although obesity is the single greatest reversible risk factor
for OSA, the 1 million Veterans with OSA and obesity rarely receive weight loss care to reverse OSA and other
serious comorbidities. Efficacy trials reinforce that time and resource intensive lifestyle-based weight loss
programs improve weight and physiologic measures of OSA severity (apnea hypopnea index, AHI). However,
there are barriers to translating these findings into meaningful gains for population health. First, VA has limited
capacity to counsel patients around lifestyle change. Less than one-third of Veterans with OSA and obesity are
counseled about weight loss and even fewer are referred to weight loss services. Second, VA’s current weight
loss offerings are difficult to access. Only 12% of Veterans with OSA and obesity utilize MOVE!, and those
referred to MOVE! achieve minimal weight loss—1.2 kg at 1 year. Third, prior weight loss trials focused on
intermediate measures (e.g. AHI), limiting understanding of effectiveness for meaningful outcomes. To meet
these challenges, we propose a pragmatic trial of proactively offering a remote video-based and self-directed
weight loss intervention with telephone-based coaching to Veterans with newly diagnosed OSA. Our weight
loss intervention (D-ELITE) is adapted from a program known to be effective in a non-VA population, with 44%
of participants achieving ≥5% weight loss at 24 months. Further optimizing reach, our remote intervention
includes low-technology options (e.g. DVD videos) to accommodate those with low technology literacy.
Significance: Our research tests a program of proactively providing Veterans with OSA the tools to manage
weight loss in a way that is independent of local provider time and resources. Our research addresses a key
gap in Veteran’s health in a way that aligns with important VA priorities including population health, virtual care,
access, and health care value. We anticipate our intervention can efficiently achieve improvements in quality of
life while reducing the burden and risk of serious comorbidities.
Innovation and Impact: Our research directly challenges the traditional provider-driven model of healthcare
delivery where providers direct care and provide necessary services aimed at managing a single disease.
Instead, we propose to proactively deliver weight loss services to a high-risk group using a population health
approach. In doing so, we will conduct the first trial of remote and self-directed weight loss care in OSA and will
test whether weight loss care can improve meaningful outcomes such as quality of life and cardiovascular risk.
Specific Aims: Our primary aim is to test the effectiveness of a proactively delivered and pragmati...

## Key facts

- **NIH application ID:** 10311958
- **Project number:** 1I01HX003319-01A1
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Lucas Matthew Donovan
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10311958

## Citation

> US National Institutes of Health, RePORTER application 10311958, Pragmatic Obstructive Sleep Apnea Weight Loss Trial Assessing Effectiveness and Reach (POWER) (1I01HX003319-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10311958. Licensed CC0.

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