Weight Loss in Primary Care: A Translation of the Diabetes Prevention Program

初级保健中的减肥：糖尿病预防计划的翻译

• 批准号: 7684796
• 负责人: PAULA MARY TRIEF
• 金额: $ 66.48万
• 依托单位: UPSTATE MEDICAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7684796
• 关键词: Academic Medical Centers; Adherence; Adopted; Behavioral; Blood Pressure; Body Weight decreased; Cardiovascular Diseases; Cardiovascular system; Clinical; Competence; Costs and Benefits; Development; Diabetes Mellitus; Dyslipidemias; Effectiveness; Empirical Research; Environment; Equilibrium; Evidence based intervention; Fasting; Fostering; Glucose; Goals; Health behavior; Health behavior outcomes; Home environment; Hypertension; Incidence; Individual; Intervention; Life Style; Lipids; Medical; Metabolic syndrome; Modeling; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Obesity; Outcome; Participant; Patients; Physical activity; Primary Care Physician; Primary Health Care; Primary Nursing Care; Public Health; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Reporting; Research; Risk; Self Determination; Site; Telephone; Translating; Translations; Visit; Weight; active method; base; cost; cost effective; cost effectiveness; diabetes prevention program; experience; follow-up; group support; health related quality of life; improved; innovation; intervention effect; peer; prevent; primary outcome; programs; psychologic; psychosocial; public health relevance; social; successful intervention; symposium; theories; weight loss intervention

DESCRIPTION (provided by applicant): Obesity is related to the rising incidence of type 2 diabetes and interventions leading to sustained weight loss are needed. Most weight loss trials have been implemented in academic centers under tightly controlled conditions with limited follow-up. The need for translation of successful interventions is clear. Since patients have regular contact with their primary care physicians (PCPs), an intervention that can be delivered through primary care practices could have better long-term outcomes. The Diabetes Prevention Program (DPP) is a model for a successful weight loss intervention, yet no programs to date have successfully adapted the DPP to a long-term primary care-based intervention. The study is a 5 year randomized controlled trial of 2 active treatment interventions based on the DPP model that will be delivered at primary care sites. The specific aims are to evaluate the effects of two interventions that are translations of the DPP Lifestyle Balance program, and are delivered through primary care practices, on the primary medical outcome of weight loss, secondary medical outcomes of blood pressure, fasting lipids and glycemia, and psychosocial outcomes of health behaviors and health-related quality of life. Secondary aims are to determine whether the DPP translation is more effective and/or cost effective delivered in a group format. Subjects will be recruited from 4 diverse primary care practices. There will be 2 active treatment groups, both based on the DPP Lifestyle Balance Program. All subjects will have contact with a primary care nurse and a behavioral weight loss "coach." During the first year, in one group, the nurse will present the 12 DPP topics during phone calls (weekly for first 5 weeks, monthly thereafter) and the coach will make 3 phone contacts per month to promote adherence to behavioral weight loss strategies. In the second group, the nurse will facilitate group conference calls (weekly for first 5 weeks, monthly thereafter) to present the DPP material and foster peer support, and the coach will have 3 weekly phone contacts for the individualized aspects of the intervention. A second year of continued contact is included. The study is significant because a primary care based, telephone weight loss intervention will be able to reach more people, may be more effective, and could be easily adopted by primary care physicians, helping them help their patients lose weight successfully and maintain their weight loss. Interventions leading to sustained weight loss are needed to improve the public health and reverse the alarming rise in diabetes, its cardiovascular complications and other obesity-related illnesses. PUBLIC HEALTH RELEVANCE: Obesity is related to the rising incidence of type 2 diabetes and interventions leading to sustained weight loss are needed. The study is significant because a primary care based, telephone-delivered weight loss intervention will be able to reach more people, may be more effective, and could be easily adopted by primary care physicians, helping them help their patients lose weight successfully and maintain their weight loss. Interventions leading to sustained weight loss are needed to improve the public health and reverse the alarming rise in diabetes, its cardiovascular complications and other obesity-related illnesses.

描述（由申请人提供）：肥胖与2型糖尿病的发生率上升有关，以及导致持续体重减轻的干预措施。大多数减肥试验已在严格控制的条件下在学术中心实施，随访有限。成功的干预措施需要翻译。由于患者与初级保健医生（PCP）定期接触，因此可以通过初级保健实践进行的干预措施可以具有更好的长期结局。糖尿病预防计划（DPP）是成功减肥干预措施的模型，但是迄今为止，迄今为止还没有成功将DPP调整为基于长期的初级保健干预措施。这项研究是一项基于DPP模型的2种主动治疗干预措施的5年随机对照试验，该试验将在初级保健站点提供。具体的目的是评估两种干预措施的影响，这些干预措施是DPP生活方式平衡计划的翻译，并通过初级保健实践，对体重减轻的主要医学结果，血压的次要医学结果，空腹脂质和血糖的次要医学结果以及健康行为的心理社会效果和健康质量的质量。次要目的是确定以小组格式交付的DPP翻译是否更有效和/或具有成本效益。受试者将从4种不同的初级保健实践中招募。将根据DPP生活方式平衡计划有2个主动治疗组。所有受试者都将与初级保健护士和行为减肥“教练”接触。在第一年，在一个小组中，护士将在电话中（每周5周，每月每月一次）提出12个DPP主题，并且教练每月将进行3次电话联系，以促进遵守行为减肥策略。在第二组中，护士将促进小组电话会议（每周5周，此后每月一次），以介绍DPP材料和寄养同伴支持，教练将每周有3个每周的电话联系，以进行干预的个性化方面。包括第二年的持续联系。这项研究很重要，因为基于初级保健，电话减肥干预措施将能够吸引更多的人，可能更有效，并且很容易被初级保健医生采用，从而帮助他们帮助患者成功减肥并保持体重减轻。需要导致持续体重减轻的干预措施来改善公共卫生并扭转糖尿病，心血管并发症和其他与肥胖相关的疾病的惊人兴起。 公共卫生相关性：肥胖与2型糖尿病的发生率的上升和干预措施有关，导致持续的体重减轻。这项研究很重要，因为基于初级保健的，提供电话的减肥干预措施将能够吸引更多的人，可能更有效，并且很容易被初级保健医生采用，帮助他们帮助患者成功减肥并保持体重减轻。需要导致持续体重减轻的干预措施来改善公共卫生并扭转糖尿病，心血管并发症和其他与肥胖相关的疾病的惊人兴起。