An ACT-enhanced Weight Management and Fitness Program for Navy Personnel

针对海军人员的 ACT 增强体重管理和健身计划

• 批准号: 9276670
• 负责人: Niloofar Afari
• 金额: $ 51.55万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9276670
• 关键词: Address; Awareness; Behavior; Biological Markers; Body Composition; Body Weight decreased; Body fat; Budgets; Cardiovascular Diseases; Caring; Clinical Research; Cognitive Therapy; Collaborations; Data; Department of Defense; Diabetes Mellitus; Diet; Disease; Eating; Eating Behavior; Effectiveness; Emotional; Ensure; Epidemic; Evidence based program; Exercise; Feasibility Studies; Feeling; Generations; Goals; Habits; Health; Health Care Costs; High Prevalence; Human Resources; Hunger; Impairment; International; Intervention; Literature; Marines; Measures; Mediating; Medical; Medical center; Medicine; Military Personnel; Morbidity - disease rate; National Security; Navy Personnel; Obesity; Operative Surgical Procedures; Outcome; Overweight; Participant; Pathologic; Physical Fitness; Physical activity; Population; Prevalence; Process; Productivity; Public Health; Quality of life; Randomized Controlled Trials; Readiness; Recommendation; Recruitment Activity; Reporting; Research; Research Design; Risk; Seizures; Stress; Testing; Thinking; Time; Training; Veterans; Weight; Weight maintenance regimen; Work; base; behavior change; bodily sensation; cohort; combat; cost; distress tolerance; effective intervention; emotional distress; evidence base; exercise program; experience; fitness; flexibility; follow-up; health record; improved; improved outcome; indexing; innovation; interest; mindfulness; mortality; negative affect; novel; organizational structure; post intervention; primary outcome; programs; psychologic; public health relevance; response; secondary outcome; service member; skills; success; therapy design

 DESCRIPTION (provided by applicant): The problem of overweight and obesity in active duty military personnel in the U.S. parallels its civilian population, reaching an all-time high of 61% or overweight and 12% for obesity. The high prevalence of overweight and obesity and inadequate fitness in active duty personnel not only impacts overall wellbeing of service members but also have significant negative consequences for a) military readiness and b) the costs associated with early attrition, reduced productivity, and medical care. The Navy and Marine Corps Public Health Center and the Navy Bureau of Medicine and Surgery are at the forefront of addressing weight and physical fitness in military personnel by developing and implementing the ShipShape (SS) program: the Navy's official program for weight management. Although SS is an evidence-based program, on average only 45% of those who complete the program are able to pass the Navy body composition assessment (BCA). The major shortcoming of SS is that it does not address the underlying psychological and emotional issues that may influence pathological eating behavior and poor exercise habits. An innovative and promising way of improving weight and fitness outcomes is to incorporate components of acceptance and commitment therapy (ACT) in order to (a) bolster participants' commitment to behavior change, (b) build distress tolerance skills, and (c) promote values-based weight-related behaviors and goals. These psychological flexibility skills should work synergistically with the dietary and physical activity recommendations of SS to improve the BCA pass rate. The aims of the proposed cohort-randomized controlled trial are to: 1) determine the effectiveness of ACT- enhanced SS (ACT+SS) compared to the standard SS-only program in 280 active duty Navy personnel; 2) examine psychological flexibility as a mechanism underlying intervention response; and 3) explore potential moderators of intervention response. Effectiveness will be measured by assessing the 6-month official BCA pass/fail status, as well as changes in body fat %, physical activity, problem eating, and quality of life from baseline to mid- and post-intervention, and 3- and 6-month follow-up. Other assessments include measures of emotional distress and psychological flexibility. Several unique factors including collaboration with the Naval Center for Combat and Operational Stress Control, active support from the Director of the Health and Wellness Department at Naval Medical Center San Diego, access to the organizational structure of the SS program for recruitment, and an internationally recognized scientific team with expertise in ACT, weight management, physical activity, and military health research ensure the successful completion of this project. Given the significant costs of overweight, obesity, and inadequate physical fitness in active duty personnel, an innovative intervention that significantly enhances weight-related outcomes in a real-world setting could be a ground- breaking step for health and wellness in U.S. service members and the military at large.

 描述（由适用提供）：美国现役军事人员超重和肥胖的问题与其平民人口平行，达到61％或超重的历史最高点，肥胖为12％。超重和肥胖症的高度流行以及现役人员的健身不足不仅会影响服务成员的整体健康状况，而且对a）军事准备和b）与早期流失，生产率降低和医疗保健相关的成本产生了重大负面影响。海军和海军陆战队公共卫生中心以及海军医学和手术局通过制定和实施造船（SS）计划来解决军事人员的体重和身体健康的最前沿：海军的官方体重管理计划。尽管SS是一个基于证据的计划，但平均只有45％的完成该计划的人能够通过海军体内组成评估（BCA）。 SS的主要缺点是，它没有解决可能影响病理饮食行为和不良运动习惯的潜在心理和情感问题。改善体重和健身成果的创新和有前途的方法是结合接受和承诺疗法（ACT）的组成部分，以增强（a）支持参与者对行为改变的承诺，（b）建立遇险耐受能力，以及（c）促进基于价值的体重相关的行为和目标。这些心理灵活性技能应与饮食和体育锻炼协同作用 SS提高BCA通过率的建议。与280名现役海军人员相比，拟议的队列随机对照试验的目的是：1）确定ACT增强SS（ACT+SS）的有效性； 2）将心理灵活性视为干预反应的基础机制； 3）探索干预反应的潜在主持人。有效性将通过评估6个月的官方BCA通过/失败状态，以及体内脂肪％，体育锻炼，饮食问题以及从基线到中期和中期和3个月的随访的变化。其他评估包括情绪困扰和心理灵活性的措施。几个独特的因素，包括与海军中心合作 战斗和运营压力控制，圣地亚哥海军医疗中心卫生和保健部主任的积极支持，访问SS招聘计划的组织结构，以及具有国际认可的科学团队，具有ACT，体重管理，体育活动，体育活动和军事健康研究的专业知识，确保成功完成了该项目。鉴于现役人员的超重，肥胖和身体健康不足的巨大成本，这种创新的干预措施可显着增强与体重相关的结果，这可能是美国服务成员和整个军事健康和整个军事健康和健康健康的开创性步骤。