Skip to main content
An official website of the United States government
Grant Details

Grant Number: 5R01CA085873-05 Interpret this number
Primary Investigator: Patrick, Kevin
Organization: University Of California San Diego
Project Title: Counseling for Overweight Women for Diet and Activity
Fiscal Year: 2005


Improved physical activity (PA) and dietary behaviors show great promise to reduce risk of cancers, CVD, NIDDM and other diseases. Improvements in PA and nutrition are particularly important for the overweight, a condition now affecting more than 50 percent of Americans. There are few effective programs for treating overweight in primary care. In this project we will evaluate an integrated clinical and home- based intervention to improve PA and dietary behaviors in overweight (BMI 25-29.9) women. PACE+ has three integrated components, a computer assessment and action planner, provider counseling; and 12 months of extended phone and mail contact. Pilot study results (n=173) demonstrate that PACE+ shows substantial promise in improving dietary and PA behaviors We will recruit 360 overweight women age 18 to 45 seen in 4 healthcare settings. Subjects will be randomly assigned to PACE+ or a usual care, delayed treatment control comparison condition. PACE+ targets three primary and three secondary behaviors: Primary: a) dietary quality (fruits and vegetables, vitamin C, carotenoids, and fiber); b) total dietary fat as a percent of energy consumed; and c) energy expenditure from moderate and vigorous physical activity during leisure-time. Secondary: a) recreational media use; b) overeating; c) saturated fat as percent of energy consumed. PACE+ also assesses stage of change and psychosocial mediators of behavior change. The PACE+ computer program guides patients to select one dietary and one PA target behavior for which they develop action or maintenance plans to discuss with the provider. The provider endorses or modifies the action plan and encourages participation in the extended phone and mail intervention. Phone counseling, mail and print materials guide the patient to use cognitive and behavioral skills to make changes in target behaviors. At six months subjects are reassessed over the phone and then continue to receive stage-appropriate intervention to address their new diet and PA goals. Primary outcomes ((a) a combined measure of energy expended in moderate and vigorous physical activity during leisure; ) an index of dietary quality encompassing increased fruits and vegetables and nutrient indicators of these foods; and (c) total dietary fat as a percent of energy consumed) will be assessed at baseline and 12 months with 7-day PA recall and food frequency questionnaires. Secondary outcomes and mediators of behavior change will be measured at baseline, 6, 12 and 24 months. Secondary outcomes include objective and self-report measures of PA and recreational media use and self-reported dietary behaviors (overeating; saturated fat intake as a percent of total energy consumed), BMI, skinfolds, waist circumference, psychosocial mediators of change. Exploratory assessment of plasma carotenoids and 24-hour dietary recall will be performed on a sub-sample of subjects to validate self report measures. The PACE+ intervention is particularly innovative in that three components - computer, primary care provider counseling, and an extended home-based intervention - are unified through a common theoretical framework.


Brief physical activity-related psychosocial measures: reliability and construct validity.
Authors: Carlson J.A. , Sallis J.F. , Wagner N. , Calfas K.J. , Patrick K. , Groesz L.M. , Norman G.J. .
Source: Journal of physical activity & health, 2012 Nov; 9(8), p. 1178-86.
EPub date: 2011-12-27.
PMID: 22207589
Related Citations

Physical activity and dietary behavior change in Internet-based weight loss interventions: comparing two multiple-behavior change indices.
Authors: Carlson J.A. , Sallis J.F. , Ramirez E.R. , Patrick K. , Norman G.J. .
Source: Preventive medicine, 2012 Jan; 54(1), p. 50-4.
EPub date: 2011-11-03.
PMID: 22085706
Related Citations

Do neighborhood environments moderate the effect of physical activity lifestyle interventions in adults?
Authors: Kerr J. , Norman G.J. , Adams M.A. , Ryan S. , Frank L. , Sallis J.F. , Calfas K.J. , Patrick K. .
Source: Health & place, 2010 Sep; 16(5), p. 903-8.
EPub date: 2010-05-11.
PMID: 20510642
Related Citations

Validating stage of change measures for physical activity and dietary behaviors for overweight women.
Authors: Robinson A.H. , Norman G.J. , Sallis J.F. , Calfas K.J. , Rock C.L. , Patrick K. .
Source: International journal of obesity (2005), 2008 Jul; 32(7), p. 1137-44.
EPub date: 2008-05-20.
PMID: 18490930
Related Citations

Patterns and correlates of multiple risk behaviors in overweight women.
Authors: Sanchez A. , Norman G.J. , Sallis J.F. , Calfas K.J. , Rock C. , Patrick K. .
Source: Preventive medicine, 2008 Mar; 46(3), p. 196-202.
EPub date: 2007-10-18.
PMID: 18022220
Related Citations

Randomized control trial of a behavioral intervention for overweight women: impact on depressive symptoms.
Authors: Kerr J. , Patrick K. , Norman G. , Stein M.B. , Calfas K. , Zabinski M. , Robinson A. .
Source: Depression and anxiety, 2008; 25(7), p. 555-8.
PMID: 17557319
Related Citations

A randomized trial of a multicomponent intervention for adolescent sun protection behaviors.
Authors: Norman G.J. , Adams M.A. , Calfas K.J. , Covin J. , Sallis J.F. , Rossi J.S. , Redding C.A. , Cella J. , Patrick K. .
Source: Archives of pediatrics & adolescent medicine, 2007 Feb; 161(2), p. 146-52.
PMID: 17283299
Related Citations

Comparability and reliability of paper- and computer-based measures of psychosocial constructs for adolescent fruit and vegetable and dietary fat intake.
Authors: Hagler A.S. , Norman G.J. , Radick L.R. , Calfas K.J. , Sallis J.F. .
Source: Journal of the American Dietetic Association, 2005 Nov; 105(11), p. 1758-64.
PMID: 16256760
Related Citations

Psychosocial and environmental correlates of adolescent sedentary behaviors.
Authors: Norman G.J. , Schmid B.A. , Sallis J.F. , Calfas K.J. , Patrick K. .
Source: Pediatrics, 2005 Oct; 116(4), p. 908-16.
PMID: 16199700
Related Citations

Comparability and reliability of paper- and computer-based measures of psychosocial constructs for adolescent physical activity and sedentary behaviors.
Authors: Norman G.J. , Sallis J.F. , Gaskins R. .
Source: Research quarterly for exercise and sport, 2005 Sep; 76(3), p. 315-23.
PMID: 16270708
Related Citations

Keeping it simple: encouraging walking as a means to active living.
Authors: Norman G.J. , Mills P.J. .
Source: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2004 Dec; 28(3), p. 149-51.
PMID: 15576251
Related Citations

Back to Top