The Bariatric Experience Long Term (BELONG) II for Racial and Ethnic Minority Patients

针对少数族裔患者的长期（BELONG）减肥体验 II

基本信息

批准号：
10210238
负责人：
Karen Jacqueline Coleman
金额：
$ 70.38万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-23 至 2023-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10210238
关键词：
Address Anxiety Area Back Bariatrics Behavioral Body Image Body Weight decreased Body mass index Caring Central obesity Chronic stress Clinical Crime Data Development Disease Eating Behavior Environmental Risk Factor Ethnic Origin Ethnography Failure Food Gastric Bypass Health Status Healthcare Systems Hispanics Hydrocortisone Individual Literature Measures Mediating Mental Depression Methods Morbid Obesity Neighborhoods Not Hispanic or Latino Obesity Operative Surgical Procedures Outcome Outcome Study Participant Patient Self-Report Patients Population Postoperative Care Poverty Predictive Factor Prevalence Procedures Qualitative Methods Race Research Sample Size Socioeconomic Status Stomach Stress Testing Weight Work bariatric surgery black patient black women care systems comorbidity coping critical period cultural values design diet and exercise effective therapy ethnic difference ethnic minority population evidence base experience follow-up health disparity innovation lifestyle intervention low socioeconomic status middle age patient oriented programs psychosocial racial and ethnic racial and ethnic disparities racial discrimination racial minority racism response social treatment choice vigilance

项目摘要

Effective treatments for severe obesity are particularly needed in racial/ethnic minority populations. Rates of severe obesity are as high as 36% for middle-aged non-Hispanic black women compared to 16% for their white counterparts in the U.S. Even with multi-component lifestyle interventions, only 50% of studies show 5% weight loss (considered clinically meaningful), and most participants gain back at least half of this lost weight over 18–30 months. These outcomes have led to the development of surgical treatments for severe obesity. When compared to diet and exercise, bariatric surgery results in much higher weight loss over a period of 24 months (75% vs. 11%). Research on bariatric weight loss outcomes among racial/ethnic minorities is limited. What evidence does exist suggests that black patients consistently lose less weight than whites over 2–3 years of follow-up. The evidence for differences between Hispanic and white or black bariatric patients is equivocal. Hispanic patients have been shown to lose more, less, or the same amount of weight as non-Hispanic black and white patients. Across studies, the disparities in % total weight loss vary from less than 2% to 10%. This variability is twice as much as the amount of weight loss considered clinically meaningful. We propose to address evidence gaps in the literature by extending the work done by our team during the Bariatric Experience Long-Term (BELONG) study which addressed how self-reported behavioral, psychosocial, and perceived environmental factors predicted weight loss over 3 years following gastric bypass and sleeve. Patients (n = 1,975) were 41% Hispanic, 17% non-Hispanic black, and 37% non-Hispanic white. The proposed study will expand the work of BELONG by incorporating: 1) A focus on weight regain during 3-5 years after surgery; 2) measures shown to contribute to health disparities in severe obesity (vigilant coping style and internalized racism); and 3) innovative qualitative methods (photo-elicitation and ethnography) to understand the patient experience. IMPACT: Results will help design patient-centered, culturally appropriate post- operative care programs so that all patients achieve the maximum benefits from this highly effective treatment. We propose the following study aims: AIM 1: Determine how environmental (social, physical); healthcare system; and patient psychosocial and behavioral factors, and health status contribute to racial/ethnic disparities in bariatric weight loss and regain after 5 years. AIM 2: Gain a deeper understanding of weight loss and regain for different races/ethnicities 5 years after surgery using qualitative methods. EXPLORATORY AIM: Explore the interaction of race/ethnicity and bariatric procedure type on weight loss and regain after 5 years.

在种族/族裔少数民族中，尤其需要对严重肥胖的有效治疗。率中年非西班牙裔黑人妇女的严重肥胖症高达36％，而她们的肥胖症则为16％美国的白人同行即使有多组分的生活方式干预，只有50％的研究显示5％体重减轻（认为临床上有意义），大多数参与者至少会减轻体重减轻的一半超过18-30个月。这些结果导致了严重肥胖症的手术治疗的发展。与饮食和运动相比，减肥手术在24个时期导致体重减轻得多月份（75％比11％）。种族/族裔少数民族中的减肥减肥结果的研究是有限的。有什么证据表明，黑人患者在2 - 3年内的体重始终比白人少。随访。西班牙裔和白人或黑色减肥患者之间差异的证据是等效的。西班牙裔患者已被证明损失了更多，更少或与非西班牙裔黑人相同的体重和白人患者。在整个研究中，％体重减轻的分布在不到2％至10％不等。这可变性是临床上有意义的减肥量的两倍。我们建议通过扩展减肥阶段的团队所做的工作来解决文献中的证据差距经验长期（属于）研究，该研究涉及自我报告的行为，社会心理和感知的环境因素预测胃旁路和袖子后3年的体重减轻。患者（n = 1,975）为41％的西班牙裔，17％的非西班牙裔黑人和37％的非西班牙裔白人。提议研究将通过合并来扩大属于属于的工作：1）在3 - 5年内关注体重的重点外科手术; 2）显示出严重肥胖的健康差异的措施（警惕应对风格和内部种族主义）； 3）了解理解的创新定性方法（光学吸气和人种志）病人的经历。影响：结果将有助于设计以患者为中心的，文化适当的后手术护理计划，使所有患者从这种高效的治疗中获得最大收益。我们提出以下研究的目的：目标1：确定环境（社会，身体）如何；卫生保健系统;患者的心理和行为因素以及健康状况有助于种族/种族减肥体重的差异，并在5年后保持。目标2：对手术后5年使用定性方法，体重减轻并留在不同种族/族裔。探索目的：探索体重类型种族/种族与减肥手术的相互作用损失并在5年后留下。