Clinical trial

Testing an Integrated PTSD and Weight Management Intervention: A Hybrid Type 1 Trial

Recruiting now · Not applicable · 1 countries · Registry ID NCT07010757

Recruiting nowNot applicableInterventional

What this study is about

Obesity and post-traumatic stress disorder (PTSD) are common among Veterans. PTSD increases risk for obesity, impacting functioning, health, quality of life, and premature mortality. Use of proven treatments for PTSD and obesity in VA is low. Furthermore, Veterans with PTSD lose less weight than those without PTSD in VA's national weight management program. Based on pilot work, an integrated treatment that combines PTSD and weight management care-using behavioral and pharmacologic approaches-may improve weight and PTSD. Whether it improves these outcomes more than standard VA care is unknown, which is the focus of this study. The study also seeks to understand factors that would interfere with and facilitate implementing the program in VA if it is effective. This Veteran-centered program may be a more efficient and effective treatment for Veterans with PTSD and obesity, addressing both physical and mental health.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age18 Years to Not listed
SexAll
Healthy volunteersNot accepted
ConditionPTSD, Obesity

Full registry criteria

Inclusion Criteria: 1. Veteran adult 2. Current PTSD Diagnosis per the revised Clinician-Administered PTSD Scale for DSM-5 (CAPS-5-R) 3. Obesity: BMI of 30 kg/m2 4. Enrolled in VA Puget Sound primary care to ensure safety and facilitate HARPP's medication component 5. Willing to do intervention or control and assessments Exclusion Criteria: 1. Not fluent in English, severe hearing loss, no phone access 2. Recent MOVE! or CPT participation (2 visits in past 2 months) 3. Had bariatric surgery in past 6 months or plans to receive it in next 12 months 4. At least 1 fill of AOM in the past 90 days 5. Current pregnancy 6. Any history of a bulimia diagnosis and/or meets criteria for bulimia 7. Cannot participate due to a) acute substance use, mental health, or medical exacerbation or b) at least moderate neurologic conditions, e.g., dementia 8. Current weight 600lbs or greater to accommodate study scale restrictions 9. Unable to complete a standing weight and height measurement to accommodate study scale restrictions

Treatments and study arms

HARPP

Behavioral

In HARPP, MOVE! and CPT are delivered in up to 16 individual psychotherapy sessions. While all CPT content is included, it is slightly tailored to address factors that interfere with health behavior change (e.g., hypervigilance that hinders community-based physical activity). All MOVE! materials are included; MOVE! uses cognitive-behavioral techniques and autonomy-supporting counseling to promote physical activity and healthy eating. HARPP targets other PTSD-related barriers to recovery and healthy lifestyles by promoting sleep and relationship quality, and community engagement. HARPP participants receive at least one medication management consultation (review by clinician and telephone session) focused on currently may cause weight gain and AOM options. When relevant and based upon Veteran interest, medications are changed or prescribed, in coordination with the Veteran's psychiatric and primary care teams.

control arm for HARPP trial

Behavioral

Participants in the control condition will receive the following: 1. Referral to MOVE!; they will select a MOVE! that fits their schedule (at VAPS MOVE! is a 12-week group). 2. Standard CPT in 60-minute individual sessions, delivered by 4 CPT-trained psychotherapists (different therapists than intervention arm therapists to avoid contamination). 3. One non-visit consult medication review using the same procedures and template outlined above. After the non-visit consult, the Dr. will alert the Veteran's relevant usual care team member(s) via the non-visit consult template in the medical record. They will not have direct contact with control participants, but the study team will monitor for safety following any medication changes.

Primary outcomes

12-month absolute weight change in pounds12 months post-baseline

Body weight will be measured on a study scale at baseline and 12 months following baseline. This study's co-primary aim is to test whether intervention participants have greater 12-month weight loss, relative to controls.

12-month absolute PTSD symptom severity change12 months post-baseline

PTSD symptom severity will be measured via self-report on the PTSD Checklist for DSM-5 at baseline and 12 months following baseline. This study's co-primary aim is to test whether intervention participants have greater 12-month PTSD symptom reduction, relative to controls.

Study locations

1 locations were listed when this page was built. The first 40 are shown.

VA Puget Sound Health Care System Seattle Division, Seattle, WA🇺🇸 Seattle, Washington, United States
Amy MarshContact
Christopher ClickContact
Katherine D Hoerster, PhD MPH BAPrincipal Investigator