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

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.

项目概要 美国大约 20% 的青少年患有肥胖症，这与许多健康问题息息相关 后果，包括导致过早死亡的心脏代谢疾病。肥胖症的治疗方法是 对于青少年来说尤其重要，因为这个年龄段的肥胖也会增加罹患低血压的风险 成年后的收入和教育程度较低。所有形式的肥胖治疗的基石是 支持日常饮食和身体活动改变的行为改变策略。自我监控是一种 基于社会认知理论的强大行为工具。该理论指出，更大的自我 通过近似的自我测量来提高认识可以提高自我效能、自我控制和自我强化。 事实证明，在家中通过每日自我称重 (SW) 自我监测体重对于以下人群来说是有效且安全的： 成年人的体重减轻和维持，特别是当家庭体重有外部责任时。 每日在家进行 SW 并对诊所负责是一种可扩展的干预措施，可以切实可行 实施到肥胖青少年的临床护理中。然而，家里的日常SW还没有 对正在寻求肥胖治疗的青少年肥胖患者进行前瞻性评估。的目标 该提案旨在评估可行性、可接受性、安全性，并估计每日SW对体重的影响 家庭，与肥胖青少年的电子健康记录 (EHR) 和临床护理相结合。我会：1） 使用混合方法确定青少年和家长对智能秤日常称重的看法 与 EHR 连接，作为寻求减肥治疗的肥胖青少年的工具； 2） 确定临床医生和诊所工作人员对与 EHR 连接的日常称重的看法；和 3) 进行一项随机、基于临床的试点研究，以比较可行性、可接受性、安全性和估计 肥胖青少年体重管理诊所中三种情况的影响大小：a) 常规护理，b) 常规护理 + 在家中以简单量表进行的日常 SW，以及 c) 常规护理 + 在家中以智能量表进行的日常 SW 与诊所相连（向患者提供个性化反馈）。我会前瞻性地、连续地评估情绪， 身体形象、压力、体重管理实践和饮食失调行为。该项目将生成 关键的初步数据，为更大规模的研究（R01）的设计提供信息，该研究全面评估安全性和有效性 肥胖青少年每天在家中进行 SW，无论是否有来自诊所的定期外部责任。 完成 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本技能，并奠定 为领先的新颖且高影响力的肥胖研究奠定基础。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、外部资助的临床科学家 谁研究基于临床的肥胖治疗干预措施。