# Optimization and Evaluation of a Tailored Behavioral eHealth/mHealth Weight Loss Intervention for Cardiac Rehabilitation Patients Using the Multiphase Optimization Strategy

> **NIH NIH K23** · MIRIAM HOSPITAL · 2020 · $175,106

## Abstract

PROJECT SUMMARY/ABSTRACT
Cardiovascular disease (CVD) is the leading cause of death in the United States. Cardiac rehabilitation (CR) is
an evidence-based, cost-effective, and widely-available multidisciplinary program that combines supervised
exercise with psychoeducation on health behavior change aimed at improving overall health and reducing
cardiovascular risk in individuals with established CVD. Despite CR's ample attention to increasing physical
activity (PA) and improving diet it produces almost no weight loss (WL). WL would significantly improve the CR
patients' health, the majority of who present to CR with obesity. Gold standard in-person behavioral weight loss
interventions (BWLs) produce clinically significant WL that improves health and disease risk/severity, but these
programs are so burdensome and costly that they are impossible to conduct within existing CR programs. The
primary mentor's fully automated 3-month online program, Rx Weight Loss (RxWL), produced clinically
significant mean±SD WL of 5.8±4.4 % of initial body weight in physician-referred patients (N=154), 5.8 ±5.2 %
in worksites (N=75), and 4.2±5.3 % in community settings (N=230); this was maintained at 6-months. Dr.
Goldstein, the candidate, aims to conduct formative work to tailor RxWL for use in CR. She will then use the
Multiphase Optimization Strategy (MOST) to rapidly screen 4 innovative eHealth/mHealth intervention
components with the potential to improve WL in this special population when combined with the core RxWL
program. Following pilot testing with n=20, a fully-powered 24 full factorial experiment with 160 patients (each
randomized to receive 0-4 of the components) will be used to test the 4 novel intervention components: (a) a
tailored interactive intervention to promote structured PA using a Fitbit; (b) a bite counting device to promote
caloric restriction; (c) a Web-based virtual reality (VR) intervention for BWL skills implementation; and (d)
virtual meetings to increase WL self-efficacy. By the 6-month follow-up, this design will allow the candidate to
determine which components maximize WL and whether there are favorable component combinations. Dr.
Goldstein will test which components are (or are not) effective and why or how they exert their effects, which is
critical for understanding their mechanism of action (or inaction). Each component will be required to meet a
2% WL optimization criterion for inclusion in the final treatment package. This research will result in a fully-
automated BWL treatment package optimized for CR, which will be submitted for testing in a randomized
controlled trial (RCT) in an R01 developed during the K23 grant period. Given the candidate's success while
earning her PhD from Kent State University and completing an NHLBI-funded Cardiovascular Behavioral
Medicine T32 at The Miriam Hospital and Brown University, the candidate will undoubtedly leverage the
resources in her exemplary research environment to develop into a su...

## Key facts

- **NIH application ID:** 9858424
- **Project number:** 5K23HL136845-03
- **Recipient organization:** MIRIAM HOSPITAL
- **Principal Investigator:** Carly Michelle Goldstein
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $175,106
- **Award type:** 5
- **Project period:** 2018-02-22 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9858424

## Citation

> US National Institutes of Health, RePORTER application 9858424, Optimization and Evaluation of a Tailored Behavioral eHealth/mHealth Weight Loss Intervention for Cardiac Rehabilitation Patients Using the Multiphase Optimization Strategy (5K23HL136845-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9858424. Licensed CC0.

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