Self-weighing for Weight Management in Adolescents with Obesity

肥胖青少年体重管理的自我称重

• 批准号: 10462745
• 负责人: Carolyn T Bramante
• 金额: $ 20.03万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-09 至 2025-08-08
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10462745
• 关键词: Accountability; Address; Adherence; Adolescence; Adolescent; Adolescent and Young Adult; Adolescent obesity; Adult; Behavior Therapy; Behavioral; Body Image; Body Weight decreased; Cardiometabolic Disease; Cessation of life; Clinic; Clinical; Counseling; Data; Development; Eating Behavior; Eating Disorders; Education; Electronic Health Record; Epidemiologic Methods; Extramural Activities; Face; Feedback; Focus Groups; Foundational Skills; Funding; Goals; Habits; Health; Height; High Prevalence; Home; Income; Intervention; Interview; K-Series Research Career Programs; Life Expectancy; Low income; Measurement; Measures; Medical; Medicine; Mentorship; Methods; Monitor; Moods; Obesity; Obesity associated disease; Parents; Patients; Physical activity; Physicians; Pilot Projects; Practice Management; Provider; Psychological reinforcement; Public Health; Randomized; Research Personnel; Risk; Safety; Scientist; Self Efficacy; Self Perception; Self-control as a personality trait; Stress; Surveys; Technology; Testing; Training Programs; Treatment Efficacy; Weight; Weight maintenance regimen; adolescent health; adolescent patient; adult obesity; age group; arm; base; cardiometabolism; clinical care; design; diabetes risk; dietary; digital; efficacy testing; evidence base; improved; individualized feedback; intervention effect; multidisciplinary; novel; obese patients; obesity treatment; premature; prospective; psychologic; remote monitoring; skills; social cognitive theory; theories; therapy design; tool; transmission process; treatment as usual; weight loss intervention; weight maintenance; Accountability; Address; Adherence; Adolescence; Adolescent; Adolescent and Young Adult; Adolescent obesity; Adult; Behavior Therapy; Behavioral; Body Image; Body Weight decreased; Cardiometabolic Disease; Cessation of life; Clinic; Clinical; Counseling; Data; Development; Eating Behavior; Eating Disorders; Education; Electronic Health Record; Epidemiologic Methods; Extramural Activities; Face; Feedback; Focus Groups; Foundational Skills; Funding; Goals; Habits; Health; Height; High Prevalence; Home; Income; Intervention; Interview; K-Series Research Career Programs; Life Expectancy; Low income; Measurement; Measures; Medical; Medicine; Mentorship; Methods; Monitor; Moods; Obesity; Obesity associated disease; Parents; Patients; Physical activity; Physicians; Pilot Projects; Practice Management; Provider; Psychological reinforcement; Public Health; Randomized; Research Personnel; Risk; Safety; Scientist; Self Efficacy; Self Perception; Self-control as a personality trait; Stress; Surveys; Technology; Testing; Training Programs; Treatment Efficacy; Weight; Weight maintenance regimen; adolescent health; adolescent patient; adult obesity; age group; arm; base; cardiometabolism; clinical care; design; diabetes risk; dietary; digital; efficacy testing; evidence base; improved; individualized feedback; intervention effect; multidisciplinary; novel; obese patients; obesity treatment; premature; prospective; psychologic; remote monitoring; skills; social cognitive theory; theories; therapy design; tool; transmission process; treatment as usual; weight loss intervention; weight maintenance

PROJECT SUMMARY Approximately 20% of adolescents in the US have obesity, which is significant because of its many health consequences, including cardiometabolic disease leading to premature death. Treatment of obesity is particularly important for adolescents because obesity in this age group also increases the risk for lower income and lower educational attainment in adulthood. The cornerstone of all forms of obesity treatment is behavioral modification strategies that support daily dietary and physical activity change. Self-monitoring is a powerful behavioral tool that is grounded in Social Cognitive Theory. This theory states that greater self- awareness through proximate self-measurement improves self-efficacy, self-control, and self-reinforcement. Self-monitoring of weight through daily self-weighing (SW) at home has been found to be effective and safe for weight loss and maintenance in adults, particularly when there is external accountability for the home weights. Daily SW at home with accountability to clinic represents a scalable intervention that can be feasibly implemented into the clinical care for adolescents with obesity. However, daily SW at home has not been prospectively assessed in adolescent patients with obesity who are seeking obesity treatment. The objective of this proposal is to evaluate the feasibility, acceptability, safety, and estimate the effect on weight of daily SW at home, integrated with the electronic health record (EHR) and clinical care of adolescents with obesity. I will: 1) Use mixed methods to determine adolescent and parent perspectives on daily weighing on smart scales connected to the EHR as a tool for adolescents with obesity who are seeking weight loss treatment; 2) Determine clinician and clinic staff perspectives on daily weighing on connected to the EHR; and 3) Conduct a randomized, clinic-based pilot study to compare the feasibility, acceptability, safety, and estimate the effect size of three conditions in a weight management clinic for adolescents with obesity: a) usual care, b) usual care + daily SW at home on a simple scale, and c) usual care + daily SW at home on a smart scale that is connected to clinic (with individualized feedback to the patient). I will prospectively and serially assess mood, body image, stress, weight management practices, and disordered eating behaviors. This project will generate critical preliminary data to inform the design of a larger study (R01) that fully evaluates safety and efficacy of daily SW at home, with and without regular external accountability from clinic, in adolescents with obesity. Completing this K23 training program will allow me to establish skills in mixed methods, epidemiologic methods and intervention design, and foundational skills in implementation of digital technology, as well as lay the groundwork for leading novel and high-impact obesity studies. The multidisciplinary mentorship during this career development award will prepare me to become an independent, extramurally-funded clinician scientist who investigates clinic-based interventions for obesity treatment.

项目摘要 美国约有20％的青少年患有肥胖症，这很重要，因为它的健康状况很多 后果，包括导致过早死亡的心脏代谢疾病。肥胖治疗是 对于青少年来说尤其重要，因为这个年龄段的肥胖症也会增加降低的风险 成年后收入和较低的教育程度。各种形式肥胖治疗的基石是 支持日常饮食和体育锻炼的行为修改策略变化。自我监控是一个 强大的行为工具以社会认知理论为基础。该理论指出，更大的自我 通过接近自我测量的意识改善了自我效能感，自我控制和自我强化。 人们发现，通过每天在家中自我降低体重（SW）对体重的自我监控已被发现有效且安全 成人的体重减轻和维护，尤其是在对家庭体重有外部责任的情况下。 对诊所问责的每日西南 针对肥胖的青少年进行临床护理。但是，每天在家中都没有 在寻求肥胖症治疗的青少年患者中进行了前瞻性评估。目的 该建议是评估可行性，可接受性，安全性，并估算对每日SW重量的影响 与肥胖症青少年的电子健康记录（EHR）和临床护理相结合的家庭。我将：1） 使用混合方法来确定每天称重的青少年和父母观点 与EHR相连，作为寻求减肥治疗的肥胖症青少年的工具； 2） 确定临床医生和诊所人员对每天称重与EHR相关的观点； 3） 进行基于诊所的随机试验研究，以比较可行性，可接受性，安全性和估计 体重管理诊所的三个条件的效果大小针对肥胖症的青少年：a）通常护理，b） 通常的护理 +每日SW在家中，c）c）通常的护理 +每天在家中，以智能的规模在家中 已连接到诊所（对患者的个性化反馈）。我将前瞻性地评估情绪， 身体形象，压力，体重管理实践和饮食行为无序。这个项目将产生 关键的初步数据，以告知大型研究（R01）的设计，该研究完全评估了安全性和功效 每天在家中，有和没有诊所的定期外部问责，在肥胖症的青少年中。 完成此K23培训计划将使我能够建立混合方法，流行病学方法的技能 和干预设计，以及实施数字技术的基础技能，并介绍 领先的新颖和高影响力肥胖研究的基础。在此期间的多学科指导 职业发展奖将使我成为一名独立的，外部资助的临床医生 谁研究了基于诊所的肥胖治疗干预措施。