Obesity is a public health crisis that has reached epidemic proportions. Although intensive behavioral interventions can produce clinically significant weight loss, their cost to implement, coupled with resource limitations, pose significant barriers to scalability. To overcome these challenges, researchers have made attempts to shift intervention content to the Internet and other mobile devices. This article systematically reviews the recent literature examining technology-supported interventions for weight loss and maintenance among overweight and obese adults. Thirteen studies were identified that satisfied our inclusion criteria (12 weight loss trials, 1 weight maintenance trial). Our findings suggest that technology interventions may be efficacious at producing weight loss. However, several studies are limited by methodologic shortcomings. There are insufficient data to evaluate their efficacy for weight maintenance. Further research is needed that employs state-of-the-art methodology, with careful attention being paid to adherence and fidelity to intervention protocols.

The fifth column on Evidence-Based Behavioral Medicine is focused on the Institute of Medicine's (IOM) report entitled "Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research." The IOM has reported that chronic pain affects 116 million American adults, which is greater than the total of heart disease, cancer, and diabetes combined. It is recommended that data collection takes place at regular intervals using standardized questions, survey protocols, and electronic medical records with the aim of the identifying the following: subpopulations at risk; characteristics of acute and chronic pain; health consequences of pain, including death, disease, and disability; and longitudinal trends of pain. In addition, health education programs should be redesigned to include information about self-management, actions to prevent injuries at the individual and community level, advocacy for pain treatment, and support for improved prevention and control policies. Through teamwork between various professions, from physicians, nurses, and psychologists to physical therapists, pharmacists, and policy makers, advancements in pain awareness, education, research, and treatment should begin to materialize.

This study examined the relationship between religiosity, spirituality and mental health in the context of a stress-coping framework. Participants were 135 rural, low-income HIV-positive adults in Iringa, Tanzania. The relationships between religiosity, spirituality, coping responses, social support, and psychological distress (depression, anxiety, and stress) were examined using structural equation modeling. Religiosity was related to decreased avoidant coping and increased social support, which in turn were related to psychological distress. Spirituality was positively related to active coping and social support. Results suggest that coping strategies and social support may mediate the relationship between religiosity and spirituality and psychological distress. Interventions to reduce psychological distress among HIV-positive individuals in Tanzania might incorporate strategies to reduce avoidant coping and increase social support. According to the present findings, this may be accomplished through faith-based approaches that incorporate religious and spiritual activities into HIV prevention programs.

Evidence-based practice (EBP) is an approach that aims to improve the process through which high-quality scientific research evidence can be obtained and translated into the best practical decisions to improve health. The interprofessional model of EBP emphasizes shared decision-making within the context of the most important advances of the various health professions. The model depicts three data streams that are integrated in the decision-making process: evidence, resources, and patient characteristics. Health professionals can play several different roles in the EBP process, including primary researchers, systematic reviewers, and clinicians. Carrying out the EBP process involves five steps, including Ask, Acquire, Appraise, Apply, and Analyze and Adjust. A new generation of research designs, such as the Sequential Multiphased Adaptive Randomized Trial, has been put forward to develop treatment algorithms that optimally capture the Apply, Analyze and Adjust steps of the EBP process. DefinitionEvidence-based practice (EBP) is an approach that aims to improve the process through which high-quality scientific research evidence can be obtained and translated into the best practical decisions to improve health. Research findings derived from the systematic collection of data through observation and experiment, as well as the formulation of questions and testing of hypotheses comprise the evidence supporting practice. EBP harmonizes the standards used to conduct, report, evaluate, and distribute research results so as to increase their application to practice and policy. EBP also involves the use of conscientious and explicit decision-making that integrates consideration of the best available research evidence, client characteristics (including preferences), and resources. Best available research is defined as contextually relevant and best in quality, according to consensually accepted scientific standards for different types of questions. Practical decisions relevant to EBP often involve the selection of an assessment or intervention. While professionals practicing evidence-based medicine (EBM) often need to choose among treatments involving drugs or devices, those practicing evidence-based behavioral medicine (EBBM) usually make selections among nondrug and nondevice behavioral or psychosocial interventions.

Results suggest that an obesity intake protocol and EHR-based weight management form may facilitate clinician weight-loss counseling among those exposed to the form. Significant implementation barriers can limit exposure, however, and need to be addressed.