DoD Campaign for Healthy Lifestyles

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• DoD Campaign for Healthy Lifestyles

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Campaign for Healthy Lifestyles

• Address the leading causes of preventable death
  (tobacco use, obesity, alcohol misuse and abuse)
  among MHS beneficiaries through evidence-based
  demonstration and pilot projects
• Evaluate the feasibility and effectiveness of
  interventions that do not currently exist as
  benefits and other programs that encourage
  healthier lifestyles for beneficiaries
• Support readiness, prevent chronic disease and
  reduce health care costs

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Tobacco-Free Me
Tobacco Cessation Demonstration Program
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Program Overview

• Objective To evaluate participation and
  effectiveness of a tobacco cessation quitline
  demonstration program in Colorado, Kansas,
  Minnesota, and areas of Missouri serviced by
  TriWest
• Implemented in May 2006 recruitment marketing
  through 30 Sep 2007 study will be complete Sep
  2008
• Eligibility TRICARE Prime enrollee
• 1864 years of age
• Non-catchment area residence (not enrolled at a
  Military Treatment Facility)

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Program Overview

• Key components 24 hour, 7 day-per-week access to
  telephone-based tobacco cessation counseling and
  includes
• Web-based tobacco cessation support, educational
  program, personalized quit kits, and access to
  nicotine replacement therapy and buproprion via
  TRICARE Mail Order Pharmacy (TMOP)
• 422 Enrolled beneficiaries
• Requirement Baseline assessment and quarterly
  follow-up surveys at 3-, 6-, 9-, and 12-months
  following enrollment

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Study Preliminary Results

• All reported cessation rates have shown increases
  in abstinence at the completion of each milestone
  quarterly survey
• 24-hour periods of cessation within the last 3
  months over each follow-up milestone ranged
  between 75.4 (at 3-month survey) to 82.4 ( at
  9-month survey)
• 7-day, 30-day, and 90-day cessation rates
  measured at the 3-month survey following
  enrollment was observed at approximately 41.2,
  33.7, and 19.8, respectively
• Cessation rates appeared to increase with each
  successive survey follow-up (6-, and 9-month
  surveys)

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Study Preliminary ResultsReported Tobacco
Cessation
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Web-Based Alcohol Abuse Prevention Education
Pilot Program

• Program for Alcohol Training, Research, and
  Online Learning (PATROL)

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Purpose of PATROL

• Develop a web-based alcohol abuse prevention and
  education program for active-duty personnel
• Assess the effectiveness of PATROL in reducing
  alcohol abuse among active-duty personnel
• Conduct a pilot study at eight installations, two
  in each service
• Army Fort Bliss, Fort Sill
• Navy Naval Station Hampton Roads-Norfolk, Naval
  Base Ventura County
• Air Force Hurlburt Field, Tyndall Air Force Base
• Marine Corps Camp Pendleton, Marine Corps
  Station Cherry Point

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Web-Based Alcohol Education Programs

• Two interactive programs
• Alcohol Savvy (AS)
• Primary prevention program
• Features audio narration and video components
• Drinkers Check-Up (DCU)
• Brief intervention for at-risk drinkers
• Features individualized feedback on drinking
• Graphics and images were developed for the
  military
• Programs use perceptions of how much same
  age/gender peers drink alcohol and encouraged
  drinking responsibly

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Number of Participants andSurvey Times
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Program Effect on Proportion of Binge Drinkers,
6-Month Follow-up

• Program effect significant for DCU (p
• Significant reduction from baseline to 1 month
  for each program group, but no change for the
  control group
• No significant changes from 1 month to 6 months
  for any groups
• Baseline program group 2, 975 participants
  Completed 6-month follow-up 859 participants

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Weight Management Demonstration Program
HEALTH Healthy Eating and Active Living in
TRICARE Households
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Program Overview

• Innovation in
• beneficiary support
• A test of the comprehensive health insurance
  benefit in promoting and maintaining weight loss
  among TRICARE Prime beneficiaries
• 4-states (Indiana, Illinois, Ohio, Michigan)
• Printed educational materials
• Web-based intervention
• Personalized telephone counseling
• Eligible for weight loss medications consistent
  with National Institute of Health guidelines
• Lessons learned may apply to AD, Guard or Reserve
  without access to military installation

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eHEALTHhttps//www.dodhealth.org/
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Program Overview

• Eligibility TRICARE Prime non-active duty
  beneficiaries who were
• Overweight with a body mass index (BMI) greater
  than 25 and less than 51
• Aged 18 to 64 years
• Residents of Indiana, Illinois, Ohio, and
  Michigan
• Program launched 26 Jul 2006
• Enrollment ended Feb 2007 study complete Sep
  2008
• Goal is for 10 loss of baseline weight at 6
  months with improved diet, exercise, and no
  weight gain

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Study Design
DEMONSTRATION STUDY
Self-directed self-motivated Less intense
intervention All data is self-reported
All enrolled participants
Participation study
Randomized Control Trial (RCT)
All participants are eligible for access to
FDA-approved weight loss medication (e.g.,
orlistat phentermine)
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Randomized Controlled Trial
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Enrollment
Total enrolled 2,471
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Measured Weight by Arm

• Preliminary results as of 11/01/2007

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Self-Reported Weight

• Preliminary results as of 11/01/2007

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Conclusion

• Beneficiary interest in weight management
  intervention is high
• Modest weight loss and lifestyle changes for a
  preliminary subset of participants who have
  reached the 6-month point
• Efficacy of behavioral weight management
  delivered by different modalities at different
  intensities of contact remains to be determined
• Sustainment of weight loss over time also to be
  determined