SystemCHANGE Weight Management in Inflammatory Immune-Mediated Diseases

SystemCHANGE 炎症免疫介导疾病的体重管理

基本信息

批准号：
8515530
负责人：
Matthew A Plow
金额：
$ 8.83万
依托单位：
CLEVELAND CLINIC LERNER COM-CWRU
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-07-23 至 2014-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8515530
关键词：
Address Adult Anxiety Autoimmune Diseases Autoimmune Process Behavior Biological Markers Body Weight Body fat C-reactive protein Cardiovascular Diseases Chronic Classification Cognitive Therapy Control Groups Data Collection Development Dietary intake Disabled Persons Disease Disease Progression Disease model Eating Educational process of instructing Emotions Ensure Evaluation F2-Isoprostanes Face Family Fatigue Flare Focus Groups Fostering General Population Goals Grant Health Health Care Costs Immune Impairment Individual Inflammation Inflammatory Interleukin-6 International Intervention Interview K-Series Research Career Programs Leptin Life Style Lower Extremity Measures Mediating Mediator of activation protein Mental Depression Mentors Methods Morphology Motivation Multiple Sclerosis Obesity Outcome Overweight Pain Participant Patient Self-Report Patients Persons Physical activity Pilot Projects Process Protocols documentation Psychosocial Factor Published Comment Randomized Recruitment Activity Research Research Activity Rheumatoid Arthritis Self Efficacy Self Management Series Sleep Social Environment Social support Solutions Stress Symptoms System Testing Time Training Training Activity Treatment Efficacy Tumor Necrosis Factor-alpha Upper Extremity Weight Weight maintenance regimen adiponectin behavior change design disability energy balance experience improved indexing intervention effect longitudinal design novel novel strategies nutrition prevent primary outcome programs psychosocial research study secondary outcome skills social statistics symptom management theories waist circumference

项目摘要

DESCRIPTION (provided by applicant): The long-term objective of this K-award is to develop an effective weight management intervention for overweight and obese adults with multiple sclerosis (MS) and rheumatoid arthritis (RA). MS and RA make good disease models to adapt the proposed intervention because they manifest similar symptoms, but are distinct enough to allow for the possibility that the intervention could be generalized across different disabling conditions in future research. The premise of this proposal is that the consequences of energy imbalance create a pro- inflammatory state that may accelerate disease progression and disability. To reduce the impact of this inflammatory state, behaviors associated with energy balance need to be addressed (ie, sleep, nutrition, and physical activity). However, these behaviors are hard to change, particularly among people with disabling conditions who often experience symptoms as barriers to a healthy lifestyle. Thus, a novel approach is needed to promote behavior change. SystemCHANGE (SC) is a promising new behavior change program that uses approaches consistent with social ecological theories and focuses on re-designing the social environment using a multiple series of small, "trial-and-error" experiments. Thus, the goal of this K-award application is to obtain a skill set to develop a program of research on adapting and testing SC weight management interventions for adults with MS and RA. The existing SC intervention targets improvements in eating, physical activity, and sleep. To make the intervention relevant to people with MS and RA, we will adapt the intervention to also support self-management skills related to pain, fatigue, depression, and stress/anxiety. The training aims of this proposal are to obtain an understanding of how to adapt and test the SC intervention using objective measures of upper and lower extremity function as well as to increase analytical and general research skills. The research aims of this proposal are to engage potential participants and their families as co- designers to adapt the SC intervention, conduct a formative evaluation of the intervention, and then conduct a randomized controlled pilot study (n=60) to provide preliminary estimates of the SC intervention's efficacy. The pilot study will provide estimates of effect size on the following primary outcomes: phenotypic indices of energy balance (e.g., weight, body fat percent), self- report measures of symptoms (e.g., fatigue and pain) and social participation, and objective measures of upper and lower-extremity function. The proposed pilot is significant because of its potential to address three of the most perplexing and prevalent health problems that we face today--inflammatory autoimmune diseases, disability, and obesity with a novel intervention.

描述（由申请人提供）：该K奖的长期目标是为具有多发性硬化症（MS）和类风湿关节炎（RA）的超重和肥胖成年人（RA）开发有效的体重管理干预措施。 MS和RA制作了良好的疾病模型以适应拟议的干预措施，因为它们表现出相似的症状，但足够明显，可以使干预措施在未来的研究中可以在不同的残疾条件上进行推广。该提议的前提是能量失衡的后果会产生一种可能加速疾病进展和残疾的炎性状态。为了减少这种炎症状态的影响，需要解决与能量平衡相关的行为（即睡眠，营养和身体活动）。但是，这些行为很难改变，尤其是在那些经常经历症状作为健康生活方式的症状的人中。因此，需要一种新颖的方法来促进行为改变。 SystemChange（SC）是一个有希望的新行为变更计划，它使用与社会生态学理论一致的方法，并着重于使用一系列小型的“试验和错误”实验来重新设计社交环境。因此，此K-award应用程序的目的是获得一项技能，以开发有关MS和RA成人适应和测试SC体重管理干预措施的研究计划。现有的SC干预措施针对饮食，体育锻炼和睡眠的改善。为了使干预措施与MS和RA的人相关，我们将适应干预措施，以支持与疼痛，疲劳，抑郁和压力/焦虑有关的自我管理技能。该建议的培训目的是了解如何使用上肢和下肢功能的客观度量以及提高分析和一般研究技能来适应和测试SC干预。该提案的研究目的是吸引潜在的参与者及其家人作为合作者，以适应SC干预措施，对干预措施进行形成性评估，然后进行随机对照试验研究（n = 60），以提供SC干预效果的初步估计。试点研究将对以下主要结果的影响大小估计：能量平衡的表型指数（例如体重，体内脂肪百分比），症状的自我报告量度（例如疲劳和疼痛）和社会参与度以及上交功能的客观度量。拟议的飞行员之所以重要，是因为它有潜力解决我们当今面临的三个最困惑和最普遍的健康问题 - 炎症自身免疫性疾病，残疾和肥胖，并进行新颖的干预措施。