Daily Self-Weighing for Obesity Management in Primary Care

初级保健中肥胖管理的每日自我称重

基本信息

批准号：
10378652
负责人：
Gareth R Dutton
金额：
$ 50.81万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-06-15 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10378652
关键词：
Accountability Adherence Adoption Adverse effects Affect Alabama Attenuated Awareness Behavior Blood Glucose Blood Pressure Body Weight decreased Body mass index Calories Caring Clinical Data Educational Materials Enrollment Exercise Feedback Fostering Guidelines Harm Reduction Health Individual Informal Social Control Instruction Intervention Monitor Obesity Observational Study Participant Patients Persons Practice Management Prevalence Prevention Primary Health Care Public Health Randomized Randomized Controlled Trials Recommendation Research Resources Societies Strategic Planning Testing Time United States National Institutes of Health Universities Weight Weight Gain Weight maintenance regimen Widespread Disease adult obesity age related care providers clinical care cost effective cost-effectiveness evaluation dietary digital effective therapy excessive weight gain health economics multi-component intervention obese patients obesity management prevent primary outcome research to practice routine care screening secondary outcome standard care theories web-enabled weight gain prevention young adult

项目摘要

PROJECT SUMMARY/ABSTRACT Most adults with obesity continue to gain weight. While primary care clinical guidelines recommend provision of, or referral to, intensive weight management treatment for patients with obesity, there are significant barriers to delivery. Even if offered, many patients do not have the time or resources to participate. Given this, along with the challenges of losing weight and keeping it off, a harm reduction framework focused on disrupting continued age-related weight gain among primary care patients with obesity may be a strategy to mitigate obesity's adverse health effects. Self-regulation theory suggests that daily self-weighing (DSW; i.e., instruction to weigh daily and monitor weight) offers a simple way to promote weight management among patients with obesity. We, and others, have shown that DSW associates with better weight management and may be ideal for primary care because of its low-burden and consistency with clinical guidelines recommending self- monitoring of health parameters such as blood pressure and glucose. However, DSW's effect when implemented in primary care among adults with obesity is unknown. Therefore, we propose conducting SWOP (Daily Self-Weighing for Obesity Management in Primary Care), a 24-month randomized controlled trial (RCT) in 400 adults with obesity (i.e., body mass index [BMI]: kg/m2 ≥30) receiving primary care through a clinical network affiliated with the University of Alabama at Birmingham (UAB). Enrolled participants will receive weight management educational materials and then randomized to DSW or standard care (SC). DSW will involve provision of a web-enabled digital scale with graphical weight feedback, while SC will involve routine care. We will test the causal effect of assignment to DSW on weight (primary outcome) and self-initiated adoption of weight management practices (secondary outcomes) over 24 months (Aim 1). We will also test the causal effect of DSW adherence on weight and weight control practices (Aim 2). Finally, we will evaluate the cost effectiveness of DSW compared to SC (Aim 3). Results will allow us to estimate whether DSW mitigates continued age-related weight gain among adults with obesity. If so, DSW could have substantial public health and economic effects by offering a weight management strategy that is feasible to implement in primary care.

项目概要/摘要大多数肥胖成年人的体重持续增加，而初级保健临床指南建议提供营养。对肥胖患者进行或转诊强化体重管理治疗存在重大障碍即使提供，许多患者也没有时间或资源参与。面对减肥和保持体重的挑战，减少危害框架的重点是破坏初级保健肥胖患者与年龄相关的体重持续增加可能是缓解肥胖的一种策略肥胖对健康的不利影响自我调节理论表明，每日自我称重（DSW；即指导）。每天称重并监测体重）提供了一种促进患有糖尿病的患者进行体重管理的简单方法我们和其他人已经证明深海水与更好的体重管理有关，并且可能是理想的选择。用于初级保健，因为其负担低且符合推荐自我治疗的临床指南监测血压和血糖等健康参数然而，DSW 的效果如何。在肥胖成人的初级保健中实施情况尚不清楚，因此，我们建议开展 SWOP。（初级保健中肥胖管理的每日自我称重），一项为期 24 个月的随机对照试验（随机对照试验）在 400 名肥胖成人（即体重指数 [BMI]：kg/m2 ≥30）中通过注册的参与者将收到隶属于伯明翰阿拉巴马大学 (UAB) 的临床网络。体重管理教育材料，然后随机进行 DSW 或标准护理 (SC)。涉及提供具有图形重量反馈的网络数字秤，而 SC 将涉及常规我们将测试 DSW 分配对体重（主要结果）和自我发起的因果影响。在 24 个月内采用体重管理实践（次要成果）（目标 1）。 DSW 坚持对体重和体重控制实践的因果影响（目标 2）。与 SC 相比，DSW 的成本效益（目标 3）使我们能够估计 DSW 是否能缓解影响。肥胖成人中与年龄相关的体重持续增加如果是这样，深海水可能会对公共健康产生重大影响。通过提供可在初级保健中实施的体重管理策略来实现经济效果。