National Veterans Health Administration MOVE! Weight Management Program Participation During the COVID-19 Pandemic

Abstract

Introduction In response to COVID-19, the Veterans Health Administration (VHA) converted appropriate outpatient visits to virtual care, including MOVE! Weight Management Program for Veterans (MOVE!) visits. Before the pandemic, most veterans participated in MOVE! in person, with several telehealth modalities available. We sought to describe national trends in MOVE! participation during the pandemic (March 2020–January 2021) overall and by modality and to compare participation to prepandemic levels. Methods We conducted a national retrospective cohort study of veterans who participated in MOVE! from January 2018 through January 2021. We examined MOVE! participation across VHA aggregated at the national level by month, including the number of visits, participants, and new participants in person and via telehealth, including telephone, clinic-to-clinic synchronous video, anywhere-to-anywhere (eg, provider home to patient home) synchronous video, and remote education and monitoring. We also determined the percentage of all MOVE! visits attributable to each modality and the monthly percentage change in participation during the pandemic compared with monthly averages in prior years. Results Before March 2020, 20% to 30% of MOVE! was delivered via telehealth, which increased to 90% by April 2020. Early in the pandemic, telephone-delivered MOVE! was the most common modality, but anywhere-to-anywhere synchronous video participation increased over time. Compared with the same months in prior years, total monthly MOVE! participation remained 20% to 40% lower at the end of 2020 and into January 2021. Conclusion The VHA MOVE! program rapidly shifted to telehealth delivery of weight management services in response to the pandemic. However, a gap remained in the number of veterans receiving these services compared with prior years, suggesting potential unmet needs for weight management.

Effect of a Remotely Delivered Self-directed Behavioral Intervention on Body Weight and Physical Health Status Among Adults With Obesity

“…For 24month outcomes, we prespecified linear mixed models that mirrored 12-month models. However, after identifying substantial missing data during model preparation (but before running the 24-month analyses), we specified models that included available data from all 3 time points and adjusted for whether the outcome was measured after the COVID-19 pandemic began, because the pandemic affected use of VA and weight-related care 7 (hence EHR data availability), and health behaviors. 31,32 The 24-month models were run following the 12-month analyses.…”

“…4 The Department of Veterans Affairs (VA) offers a free interactive behavioral weight management program called MOVE!, but a 2018 systematic review reported 2% to 12% of eligible patients participate, 5 and data from [2005][2006][2007][2008] showed that travel distance was a barrier to participation. 6 Although the VA has expanded telemedicine for weight management, 7 there are insufficient personnel to screen, refer, and deliver the intervention. 5 Self-directed programs that rely on patient initiative rather than a facilitator may overcome these barriers.…”