APP-ME: Addressing Place & People MicroEnvironments in weight loss disparities

APP-ME：地址地点

基本信息

批准号：
9268777
负责人：
DANIEL O CLARK
金额：
$ 64.18万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-02 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9268777
关键词：
Accelerometer Address Affect African American Age Awareness Back Behavior Bite Body Size Body Weight Changes Body Weight decreased Calories Cause of Death Cellular Phone Charge Conscious Cues Data Data Collection Decision Making Eating Eating Behavior Ecological momentary assessment Emotions Energy Metabolism Environment Exposure to Fatty acid glycerol esters Federally Qualified Health Center Food Goals Health Health system Healthy People 2010 Home environment Human Hybrids Hypertension Image Individual Intention Interruption Intervention Intervention Trial Lead Life Life Style Literature Location Measures Methods Mind Modeling Morbidity - disease rate Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Outcome Participant Persons Prevalence Provider Randomized Reporting Research Risk Risk Reduction Role Scientist Site Smell Perception Social Environment Social Interaction Social Network Social support Sodium Source Stimulus Stroke Testing Time Translating Weight Weight Gain Weight maintenance regimen Woman Work arm design disparities in morbidity experience experimental study fast food health disparity improved lifestyle intervention member middle age next generation novel novel strategies obesogenic programs public health relevance racial disparity randomized trial reconstruction response safety net sedentary activity sedentary lifestyle smoking cessation social sugar tailored messaging tool treatment as usual weight loss intervention

项目摘要

DESCRIPTION (provided by applicant): Multi-site RCTs have shown that every 2lbs of weight loss is associated with a 20% reduction in the 3yr risk of hypertension and a 32% reduction in the 3yr risk of type 2 diabetes. This is equivalent to the stroke risk reduction associated with smoking cessation. Unfortunately, in intervention trials dating back to 1990, black women have experienced 50% less weight loss than white women. Thus, lifestyle weight loss interventions may actually increase racial disparities in morbidity; all 5 leading causes of death among black women are obesity-related. Obesity prevalence among the urban poor is very high and obesity research in the urban poor is an IOM and DHHS priority. Starting in 2006, we worked with the 3rd largest safety-net health system in the U.S. to implement a lifestyle weight loss intervention that operates in its 8 Federally Qualified Health Centers. This program too has resulted in 50% less weight loss in black relative to white women. We also have an ongoing weight loss RCT testing the impact of delivering the intervention into the homes of the urban poor. No outcomes are available yet but it too is a person-centric lifestyle intervention. With a goal of improving weight loss outcomes, we successfully piloted a novel approach to assessing micro- environments that coincide with weight-related behaviors including momentary social interactions and emotions. Literature places a very strong emphasis on the role of social micro-environments in obesity and weight loss disparities. Individuals are often unaware of the influence of micro-environments on their behavior. For example, experiments have shown that we consume up to 70% more calories when eating with others and that we are largely unaware we have done so. Previous research suggests social networks of black women are less supportive of weight loss than are those of white women. Such social networks may lead to more exposures to obesity, food, eating, sedentary activities, and acceptance of these. In fact, a recent year-long study that captured objective assessments of social interactions among first year dormitory residents found the number of interactions with weight gaining others accounted for 1/3rd of the variance in one-year weight gain. We seek in the proposed study to assess, compare, and test the influence of social and physical micro- environments and emotions on inactivity and eating in 300 urban poor black and white women. Our Aim 1 involves novel data collection via GPS, Bite Counters, and accelerometers to obtain location and behavior data and a hybrid of ecological momentary assessment and the day reconstruction method to obtain social interaction and emotion data. In our Aim 2 randomized trial, these data are used to test hypotheses about micro-environments and weight change. Each individual's Aim 1 data are used to test whether messages in the form of health-related words and images at the time and location each woman's data indicate she is vulnerable to eating or sedentary activity affect weight change. This work will inform next-generation weight loss programs and advance our understanding of automatic behaviors in health and health disparities.

描述（通过应用程序证明）：多站点的RCT具有减肥的帽子电动汽车，与2型糖尿病的3岁风险降低了32％与白人妇女相比，重量减少1990％。美国的卫生系统在其8个联邦合格的卫生中心中实施了一种生活方式减肥式介入，这也导致黑色架子相对于白人妇女的体重减少了50％。通过将干预措施交付给城市穷人肥胖和体重减轻是微环境对Xperiments的影响，表明我们与他人的卡路里多达70％，并且我们在很大程度上已经这样做了。与白人妇女相比，这种社交网络可能会导致对第一年宿舍居民之间社交互动的曝光，发现与其他人的互动数量占了一年中体重增加的1/3。我们看到的 - 亲自评估和测试社会物理的影响。行为数据和生态妈妈的评估和日期的重新构造方法在我们的AIM 2随机试验中获得社交互动和情感数据。表明她容易饮食或久坐的活动会影响体重的变化。