- MOVE! is a weight-management program available to veterans at U.S. Department of Veterans’ Affairs (VA) Medical Centers and Community-Based Outpatient Clinics.
- Over 400,000 veterans have participated since 2005.
- People can take the brief MOVE!11 questionnaire online to get an individual assessment of weight management factors.
- The curriculum has been converted into a self-guided app, MOVE! Coach, which is available for free for any interested user (iOS devices only).
- The program’s foundation in an existing national system – the VA – means that participants stay in the same system long enough for the VA to see the returns of its own investment.
Summary
The VHA created the MOVE! weight management program as a cornerstone effort of the VHA National Center for Health Promotion and Disease Prevention (NCP). MOVE! was piloted in 2003–2005 and introduced nationwide in 2006.[1] The program offers a 19-week lifestyle-change curriculum for weight loss, available in all VA Medical Centers, as well as in many VA Community-Based Outpatient Clinics throughout the country.[2] It also offers a large collection of handouts and other resources available for free online through the VA website.[3]The MOVE! 11 questionnaire, which can also be taken on the website for free, is an eleven-question survey meant to identify the aspects of an individual’s life that are most relevant to their own weight loss, asking about availability of family and peer support, mental health conditions, self-reported reasons for weight gain and barriers to lifestyle change, and diet and physical activity habits.[4] The online questionnaire produces an individualized report with links to handouts based on responses, as well as a complementary report for the respondent’s physician.
While the in-person program is only available to veterans who receive medical care through the VA, this represents a substantial population: over 400,000 veterans have participated since 2005.[5] The VA has also taken several steps to make the MOVE! curriculum more accessible to others. The MOVE!11 questionnaire, as well as all handouts and worksheets, are available to anyone for free on the program’s website. In addition, the VA introduced MOVE! Coach, a self-guided app version of the MOVE! curriculum. MOVE! Coach is free for anyone to use, although it is currently only available for iOS devices (iPhone and iPad).
Analysis
MOVE! is an excellent example of how an existing structure—the VA—can be used to reach a very large population—veterans—many of whom may be at high risk for type 2 diabetes. Because participants are drawn from a common population, MOVE! groups are naturally conducive to creating a sense of camaraderie and shared goals during the in-person sessions. It should be noted that MOVE! is a weight management program and not specifically a diabetes prevention program; the curriculum, however, has many parallels to typical DPPs and has been associated with reduced incidence of type 2 diabetes. The focus on weight, in particular, has the potential to draw a larger participant population, as it does not require a prior screening for prediabetes. In addition, the fact that this program is run through the VA addresses one other frequent challenge to the cost-effectiveness of many prevention efforts: the same people who invest in prevention will reap the benefits of savings that occur years down the road. Often, payers have disincentives on reimbursement for prevention, as high turnover rates mean that others often gain the returns on that investment. Because the VA is a national system through which veterans often receive care and coverage for decades, there is increased potential for an alignment of investments and returns.
The major limitation to using the VA as the organizing body is, of course, that only veterans can benefit. While the VA’s national presence provides some opportunity for scale, as evidenced by the fact that all VA medical centers offer MOVE!, the scalability is restricted only to the one particular population. Many of the advantages of MOVE!, especially the group unity that comes from the common identity of participants and the ease of accessing the target population, would be lost if MOVE! were to be copied outside of the VA. The MOVE! Coach app and the other available online resources do, of course, represent a step in expanding the program’s potential impact, but more work will need to be done to determine how lessons learned by the VA might be translated to other populations.
- “Legacy of Accomplishment: NCP Celebrates 20 Years of Successes in VA Prevention,” National Center for Health Promotion and Disease Prevention, 2015, http://www.prevention.va.gov/Publications/Newsletters/2015/HealthPOWER_Prevention_News_Fall_2015_Feature_Article.asp.
- “MOVE! Weight Management Program,” U.S. Department of Veterans Affairs, August 1, 2016, https://www.move.va.gov.
- Ibid.
- Ibid.
- Steven Spotswood, “VA’s MOVE! Program Touted as Model for Combating Diabetes, Obesity,” U.S. Medicine, 2013, http://www.usmedicine.com/agencies/department-of-defense-dod/army/vas-move-program-touted-as-model-for-combating-diabetes-obesity/.
