# WOOP VA: Mental Contrasting With Implementation Intentions to Promote Weight Management in Primary Care

> **NIH VA I01** · VA  MEDICAL CENTER · 2024 · —

## Abstract

Background: Approximately 40% of Veterans have obesity. Intensive weight management
programs such as MOVE! promote clinically significant weight loss, but only 3-7% of eligible
Veterans attend. Low enrollment and high attrition are due to obstacles such as travel, cost, and
motivation. Developed through over 20 years of research, Mental Contrasting with
Implementation Intentions (MCII) is a novel, evidence-based intervention to increase motivation
and behavior change. MCII has been shown to increase physical activity and consumption of
fruits and vegetables and promote weight loss, and we recently demonstrated that MCII is
feasible and acceptable to Veterans for weight management. However, has not been tested
adequately within primary care nor demonstrated weight loss in Veterans. We propose to
evaluate the efficacy and implementation of MCII for behavior change and weight loss in
Veterans within primary care when combined with the VA MOVE! Program.
Significance/Impact: This proposal aligns with the VA HSRD “primary care practice and
management of complex chronic diseases” funding priority. Primary care providers and PACT
members do not provide sufficient counseling to increase engagement with the MOVE!
Program. MCII can be taught by lay educators and can be delivered in conjunction with MOVE!
and other weight management treatments.
Innovation: MCII is innovative in its use of imagery, ease of delivery by lay educators, novel
mechanisms of action (via non-conscious motivational and cognitive processes), and ability to
be combined with other programs. Veterans can practice MCII on their own in under 10 minutes.
MCII uses a standardized, 4-step imagery procedure called WOOP that can be taught in 30
minutes. Veterans can then continue to use WOOP regularly, with the assistance of a WOOP
App and website containing video-, audio-, and paper-based tools. This study will be the first
randomized controlled trial of MCII within primary care and the first RCT to test the efficacy and
implementation of MCII for weight management when combined with MOVE! in Veterans.
Specific Aims: 1. Compare the impact of MCII + MOVE! vs. MOVE! alone on percent weight
change and waist circumference at 6 and 12 months. 2. Compare the impact of MCII + MOVE!
vs. MOVE! alone on MOVE! attendance, physical activity, and healthy eating at 6 and 12
months. 3. Evaluate implementation of MCII. We will use the Reach, Effectiveness, Adoption,
Implementation, Maintenance (RE-AIM) framework7,8 to evaluate implementation barriers,
facilitators, and outcomes of MCII.
Methodology: We will randomize 366 Veterans within primary care to either MCII + telephone-
delivered MOVE! (intervention) vs. telephone-delivered MOVE! alone (control) at the Manhattan
VA. At 6 and 12 months, participants will return to the clinic for a study visit where weight, diet,
and physical activity will be assessed in both groups. We will use intention-to-treat analyses.
Implementation/Next Steps: MCII is designed to ...

## Key facts

- **NIH application ID:** 10929436
- **Project number:** 5I01HX003264-04
- **Recipient organization:** VA  MEDICAL CENTER
- **Principal Investigator:** Melanie Jay
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10929436

## Citation

> US National Institutes of Health, RePORTER application 10929436, WOOP VA: Mental Contrasting With Implementation Intentions to Promote Weight Management in Primary Care (5I01HX003264-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10929436. Licensed CC0.

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