Integrated Clinical-Behavioral Interventions to Accomplish Weight Loss

综合临床行为干预来实现减肥

• 批准号: 7480353
• 负责人: LAWRENCE JOHN APPEL
• 金额: $ 126.16万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-25 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7480353
• 关键词: Adult; Behavior Therapy; Behavioral; Body Weight decreased; Body mass index; Clinic; Clinical; Communication; Data; Direct Costs; Disease Management; Effectiveness; Electronic Mail; Evidence based program; Fasting; Feedback; Foundations; Glucose; Goals; Health; Hospitals; Hypertension; Individual; Insulin; Insurance Carriers; Internet; Intervention; Intervention Trial; Lipids; Medical; Monitor; Obesity; Online Systems; Outcome; Overweight; Participant; Patients; Persons; Pharmaceutical Preparations; Primary Health Care; Professional counselor; Provider; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Research; Research Personnel; Resources; Risk; Risk Factors; Score; Techniques; Telephone; Testing; Training; Translations; Treatment Efficacy; Triglycerides; Upper arm; Visit; Weight; Weight maintenance regimen; Wellness Program; cardiovascular disorder risk; comparison group; cost; efficacy trial; follow-up; improved; indexing; programs; theories; tool

DESCRIPTION (provided by applicant): An extensive body of evidence from efficacy trials, including several behavioral intervention trials conducted by the Hopkins investigators, has documented that weight loss is achievable. However, primary care providers typically had no direct involvement in the interventions. We propose a 3 group, randomized trial to determine the effectiveness of two integrated clinical-behavioral interventions (ICBIs). Participants will be 300 overweight or obese individuals with medication-treated hypertension, who are patients at two primary care clinics. The comparison group, as well as both ICBIs, will receive an evidence-based program to improve hypertension control. One ICBI, termed ICBI-IP, is a multi-channel intervention with in-person visits delivered by health counselors at the Hopkins center. This intervention is similar to traditional in-person interventions tested in efficacy trials; however, some in-person contacts are replaced with other types of contacts (telephone, web, email) in order to reduce costs and improve efficiency. The other ICBI, termed ICBI-Remote, is a multi-channel intervention (telephone, web, email) without in-person visits implemented by trained counselors of Healthways, Inc, a leading Disease Management company. This research effort builds upon previous research conducted by the investigators. Both ICBIs will be theory-guided interventions, adapted from PREMIER, an efficacy trial in which interventions lowered weight and controlled hypertension. Each ICBI will implement well-established behavioral techniques to accomplish weight loss, and each will use a web-based tool to facilitate communication among counselors, participants and clinicians; self- monitoring by participants; and feedback by counselors and clinicians. Both ICBIs will actively engage primary care providers. The primary outcome variable will be BMI and the secondary outcome hypertension control. Both ICBI should reduce weight. Critical questions are the extent of weight loss from each program. ICBI-IP might reduce weight to a greater extent than ICBI-Remote. Still, ICBI-Remote should be less expensive and more flexible. ICBI-IP could be implemented in a variety of settings (e.g. wellness programs, large clinics), while ICBI-Remote has the advantage of being readily 'scalable', that is, if successful, it could be rapidly implemented. In short, this translation study should provide the scientific foundation for efforts to control weight and improve hypertension control in overweight or obese medical patients.

描述（由申请人提供）： 有效试验中的大量证据，包括霍普金斯研究人员进行的几项行为干预试验，已证明可以实现减肥。但是，初级保健提供者通常没有直接参与干预措施。我们提出了一个3组随机试验，以确定两种综合临床行为干预措施（冰比）的有效性。参与者将是300名超重或肥胖的患者，患有药物治疗的高血压，他们是两个初级保健诊所的患者。比较组以及两个冰比人都将获得一项基于证据的计划，以改善高血压控制。一个被称为ICBI-IP的洲际弹道导弹是一种多渠道干预措施，由霍普金斯中心的卫生顾问进行现场访问。这种干预措施类似于在功效试验中测试的传统面对面干预措施。但是，某些面对面的联系人被其他类型的联系人（电话，网络，电子邮件）代替，以降低成本并提高效率。另一个被称为洲际绝型杂志的洲际弹体是一项多渠道干预（电话，网络，电子邮件），而没有由培训的疾病管理公司Healthways，Inc进行的亲自访问。这项研究工作是基于研究人员先前进行的研究。这两个冰球是理论引导的干预措施，均改编自Premier，这是一项疗效试验，其中干预措施降低了体重和受控的高血压。每个洲权将实施良好的行为技术来实现减肥，每种行为技巧都将使用基于网络的工具来促进辅导员，参与者和临床医生之间的交流；参与者的自我监控；以及辅导员和临床医生的反馈。这两个冰比人都将积极与初级保健提供者联系。主要结果变量将是BMI和次级结果高血压控制。两种洲际弹药都应减轻体重。关键问题是每个程序减肥的程度。 ICBI-IP可能比iCbi-remote更大程度地减轻体重。尽管如此，洲际绝型杂志应该更便宜且更灵活。 ICBI-IP可以在各种环境（例如健康计划，大型诊所）中实施，而iCbi-Remote具有容易“可扩展”的优势，也就是说，如果成功，它可以迅速实施。简而言之，这项翻译研究应为控制体重和改善超重或肥胖医疗患者的高血压控制的努力提供科学基础。