--- title: "Research Aimed at Improving Both Mood and Weight (RAINBOW). | Sutter Health" description: "Obese and depressed adults will be randomized to usual care enhanced with the provision of a pedometer and mood and wt. mgmt info, or I-CARE program." url: "https://www.sutterhealth.org/research/publications/research-aimed-at-improving-both-mood-and-wt-1055312852" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Research Aimed at Improving Both Mood and Weight (RAINBOW). # Research Aimed at Improving Both Mood and Weight (RAINBOW) in Primary Care: A Type 1 hybrid design randomized controlled trial. Ma J, Yank V, Lv N, Goldhaber-Fiebert JD, Lewis MA, Kaye Kramer M, Snowden MB, Rosas LG, Xiao L, & Blonstein AC. _Contemp Clin Trials. 43:260-78. doi: 10.1016/j.cct.2015.06.010. Epub 2015 June 19._ 2015-07-01 ## Abstract Effective interventions targeting comorbid obesity and depression are critical given the increasing prevalence and worsened outcomes for patients with both conditions. RAINBOW is a type 1 hybrid design randomized controlled trial. The objective is to evaluate the clinical and cost effectiveness and implementation potential of an integrated, technology-enhanced, collaborative care model for treating comorbid obesity and depression in primary care. Obese and depressed adults (n=404) will be randomized to usual care enhanced with the provision of a pedometer and information about the health system's services for mood or weight management (control) or with the Integrated Coaching for Better Mood and Weight (I-CARE) program (intervention). The 12-month I-CARE program synergistically integrates two proven behavioral interventions: problem-solving therapy with as-needed intensification of pharmacotherapy for depression (PEARLS) and standardized behavioral treatment for obesity (Group Lifestyle Balance™). It utilizes traditional (e.g., office visits and phone consults) and emerging care delivery modalities (e.g., patient web portal and mobile applications). Follow-up assessments will occur at 6, 12, 18, and 24 months. We hypothesize that compared with controls, I-CARE participants will have greater improvements in weight and depression severity measured by the 20-item Depression Symptom Checklist at 12months, which will be sustained at 24months. We will also assess I-CARE's cost-effectiveness and use mixed methods to examine its potential for reach, adoption, implementation, and maintenance. This study offers the potential to change how obese and depressed adults are treated-through a new model of accessible and integrative lifestyle medicine and mental health expertise-in primary care. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/26096714) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Diabetes, Insulin Resistance and Metabolic Syndrome](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Diabetes%2C+Insulin+Resistance+and+Metabolic+Syndrome%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [The Electronic CardioMetabolic Program (eCMP) for patients with cardiometabolic risk: a randomized controlled trial.](https://www.sutterhealth.org/research/publications/electronic-cardiometabolic-program-1055312305) Azar KM, Koliwad S, Poon T, Xiao L, Lv N, Griggs R, Ma J. J Med Internet Res. 18(5):e134. doi: 10.2196/jmir.5143. 2016 May 27 - Publication ### [A conceptual model of the role of complexity in the care of patients with multiple chronic conditions.](https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633) Grembowski D, Schaefer J, Johnson KE, Fischer H, Moore SL, Tai-Seale M, Ricciardi R, Fraser JR, Miller D, LeRoy L; AHRQ MCC Research Network. Med Care. 52 Suppl 3:S7-S14. doi: 10.1097/MLR.0000000000000045. 2014 Mar 01 - Publication ### [Behavioral lifestyle interventions for moderate and severe obesity: a systematic review.](https://www.sutterhealth.org/research/publications/beh-lifestyle-interventions-mod-severe-obesity-1055312350) Lv N, Azar KMJ, Rosas LG, Wulfovich S, Xiao L, Ma J. Prev Med. pii: S0091-7435(17)30142-1. doi: 10.1016/j.ypmed.2017.04.022. \[Epub ahead of print\] 2017 Apr 24 - Publication ### [Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): a randomized controlled trial.](https://www.sutterhealth.org/research/publications/eval-outpt-diabetes-prev-prog-latino-adults-1055312475) Rosas LG, Lv N, Xiao L, Lewis M, Zavella P, Kramer MK, Luna V, Ma J. Contemp Clin Trials. pii: S1551-7144(16)30029-5. doi: 10.1016/j.cct.2016.03.003. \[Epub ahead of print\] 2016 Mar 16 - Publication ### [A Latino Patient-Centered, Evidence-Based Approach to Diabetes Prevention.](https://www.sutterhealth.org/research/publications/latino-pt-centered-evidence-based-approach-to-dm-prevention-1055312326) Rosas LG, Lv N, Lewis MA, Venditti EM, Zavella P, Luna V, Ma J. J Am Board Fam Med. 31(3):364-374. doi: 10.3122/jabfm.2018.03.170280. 2018 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/research-aimed-at-improving-both-mood-and-wt-1055312852#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Research Aimed at Improving Both Mood and Weight (RAINBOW)."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/research-aimed-at-improving-both-mood-and-wt-1055312852#medicalscholarlyarticle","name":"Research Aimed at Improving Both Mood and Weight (RAINBOW) in Primary Care: A Type 1 hybrid design randomized controlled trial.","headline":"Research Aimed at Improving Both Mood and Weight (RAINBOW).","abstract":"Effective interventions targeting comorbid obesity and depression are critical given the increasing prevalence and worsened outcomes for patients with both conditions. RAINBOW is a type 1 hybrid design randomized controlled trial. The objective is to evaluate the clinical and cost effectiveness and implementation potential of an integrated, technology-enhanced, collaborative care model for treating comorbid obesity and depression in primary care. Obese and depressed adults (n=404) will be randomized to usual care enhanced with the provision of a pedometer and information about the health system's services for mood or weight management (control) or with the Integrated Coaching for Better Mood and Weight (I-CARE) program (intervention). The 12-month I-CARE program synergistically integrates two proven behavioral interventions: problem-solving therapy with as-needed intensification of pharmacotherapy for depression (PEARLS) and standardized behavioral treatment for obesity (Group Lifestyle Balance™). It utilizes traditional (e.g., office visits and phone consults) and emerging care delivery modalities (e.g., patient web portal and mobile applications). Follow-up assessments will occur at 6, 12, 18, and 24 months. We hypothesize that compared with controls, I-CARE participants will have greater improvements in weight and depression severity measured by the 20-item Depression Symptom Checklist at 12months, which will be sustained at 24months. We will also assess I-CARE's cost-effectiveness and use mixed methods to examine its potential for reach, adoption, implementation, and maintenance. 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