This week we spotlight Cincinnati Veterans Affairs (VA) Management of Overweight/Obesity for Veterans Everywhere Program (MOVE!), an evidence-based lifestyle program for veterans.
The Program Basics
According to Stephanie Ciccarella, Cincinnati VA utilizes a 2-step process to promote readiness to change. The first step offers education on nutrition, behavioral habits, and physical activity. The second step emphasizes action, like journaling, physical activity, and problem-solving personal habits. Training is offered twice a week under the supervision of a physical therapist with cardiovascular, strength training, and education during 2-hour classes. Personal accountability is the cornerstone of the program.
Veterans begin the second step with education on the importance of regular daily activity. Each person is issued a pedometer and instructed to track their daily steps. Veterans are able to see changes in their activity levels reflected in their journals and set goals. By the end of the program, veterans take lead roles by leading exercise and supporting each other through problem solving and motivation.
Measuring Success
“Emphasis on performance and outcome measures are keys to determining effectiveness of the program,” says Ciccarella. “They help guide program development.”
The Cincinnati MOVE! Phase II program utilizes additional evidence-based outcome measures to help guide the development of physical activity training and education during meetings. These outcome measures (listed below) help indicate ability to successfully participate in semi-intensive exercise, degree of health risk, and improvement in function. By reviewing pre- and post assessment measures, each group member is able to see his or her specific improvement.
Challenges and Program Shortcomings
“One of the primary shortcomings of this program is its length,” says Ciccarella. A longer program would ensure a more thorough change in behavior and demonstrate greater physical progress. Another drawback to the program is geographic availability. Evidence demonstrates that people are more likely to maintain a physical activity schedule when resources are available within 10 miles of their homes. Some veterans must travel significant distances to participate. Veterans are also required to commit a significant amount of time over a 6-week period. This poses a problem for those who work, have children, or go to school. Given the nature of weight loss, the benefits of participation may not be dramatic enough to maintain motivation. Some of the proposed answers to these problems include lengthening the program to 9 or 12 weeks, expanding Physical Therapy Clinics in all outpatient settings, and introducing more flexible scheduling.
Outcome Measures
| Berg balance scale | Perceived wellness survey |
| Montreal cognitive assessment | Gait speed |
| Weight/BMI | 6- minute walk test |
| Rate of perceived exertion | Vital signs |
| Readiness to change |
Implementing a Similar Program in Your Community
Cincinatti VA tailored the national MOVE! Program to fit their specific needs. To implement the program in your area, check out the original MOVE! Program at: http://www.move.va.gov/ and see how it can work for you.
How could you tailor the MOVE! program for your area?
Are you interested in having your program spotlighted? Leave a comment below and we will contact you with more information.