Randomized Trial of Tapas Acupressure for Weight Loss Maintenance

塔帕斯穴位按摩维持减肥的随机试验

基本信息

批准号：
7579003
负责人：
CHARLES R ELDER
金额：
$ 58.49万
依托单位：
KAISER FOUNDATION RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-01 至 2011-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7579003
关键词：
Acupressure Acupuncture Points Adult Affect American Behavior Therapy Behavioral Belief Body Weight Changes Body Weight decreased Cardiovascular Diseases Caring Cessation of life Characteristics Chinese People Communities Complementary and alternative medicine Control Groups Control Locus Diet Educational process of instructing Eligibility Determination Epidemic Funding Group Meetings Guidelines Health Home environment Hour Hyperlipidemia Hypertension Image Instruction Intervention Maintenance Malignant Neoplasms Managed Care Measures Mediating Mediator of activation protein Medicine Methodology Mind Mind-Body Intervention Monitor National Center for Complementary and Alternative Medicine Non-Insulin-Dependent Diabetes Mellitus Obesity Overweight Participant Patients Physical activity Procedures Psyche structure Psychosocial Stress Public Health Quality of life Questionnaires Randomized Randomized Clinical Trials Randomized Controlled Clinical Trials Recruitment Activity Research Risk Factors Stress Support Groups Techniques Testing United States Weight Gain Weight maintenance regimen Yin base cardiovascular disorder risk cost depression effective intervention experience follow-up food craving intervention effect meetings pilot trial pressure prevent primary outcome psychosocial satisfaction secondary outcome self esteem tool treatment as usual weight loss intervention weight maintenance

项目摘要

DESCRIPTION (provided by applicant): Overweight and obesity are the second leading cause of preventable death, primarily through effects on cardiovascular disease (CVD) risk factors and cancer. Despite inclusion of weight control as a core component of treatment guidelines for hypertension, hyperlipidemia, and type 2 diabetes, the obesity epidemic continues to grow, affecting over 100 million Americans. A major factor contributing to this escalating epidemic is the disappointingly common phenomenon of re-gain of weight after successful initial weight loss. We recently completed a pilot trial assessing the feasibility and impact of two mind-body interventions from the Chinese Medicine tradition for weight loss maintenance in overweight and obese adults. Results of the pilot suggested that the Tapas Acupressure Technique (TAT) warrants further research as a potential tool for weight loss maintenance. The TAT procedure combines self-acupressure administration with specific mental focus. Patients are taught how to first identify counterproductive beliefs and actions, focus on those images while applying pressure to acupoints GB21, BL1, and Yin Tang, and then transition to a focus on positive images. We now propose a randomized clinical trial evaluating the efficacy of TAT compared to a usual care control support group for the primary outcome of weight loss maintenance. We will recruit obese and overweight adults from community and managed care settings. Those meeting eligibility requirements will be assigned to a 20-week intensive group-based behavioral weight loss intervention. Approximately 288 patients who upon completion of the weight loss component meet threshold weight loss criteria will then be randomly assigned to either TAT instruction or the facilitated support group control. Patients in both groups will attend a total of 8 group meetings over 6 months for a total of 13 contact hours, and patients in the TAT group will be advised to practice the technique at home. Participants will be weighed at baseline, randomization, and then again at 3, 6, 9, and 12 months. Questionnaires will also be administered at baseline and one year follow-up toward measuring both secondary outcomes (quality of life and psychosocial function) and potential mediators (diet, physical activity, food cravings, psychosocial stress). Statistically significant improvements in weight loss maintenance in the proposed trial could indicate inclusion of TAT as a standard weight loss maintenance intervention within the conventional care setting. The relevance of this research to public health is: Overweight and obesity are the second leading cause of preventable death, primarily through effects on cardiovascular disease (CVD) risk factors and cancer. Despite inclusion of weight control as a core component of treatment guidelines for hypertension, hyperlipidemia, and type 2 diabetes, the obesity epidemic continues to grow, affecting over 100 million Americans.

描述（由申请人提供）：超重和肥胖是可预防死亡的第二大原因，主要是通过影响心血管疾病 (CVD) 危险因素和癌症。尽管将体重控制作为高血压、高脂血症和 2 型糖尿病治疗指南的核心组成部分，但肥胖流行病仍在继续增长，影响了超过 1 亿美国人。导致这种流行病不断升级的一个主要因素是令人失望的普遍现象，即在最初成功减肥后体重又重新增加。我们最近完成了一项试点试验，评估两种中医传统身心干预措施对超重和肥胖成年人维持减肥的可行性和影响。试点结果表明，Tapas 指压技术 (TAT) 值得进一步研究，作为维持减肥的潜在工具。 TAT 程序将自我穴位按摩与特定的精神集中相结合。教导患者如何首先识别适得其反的信念和行为，在对 GB21、BL1 和印堂穴位施加压力的同时将注意力集中在这些图像上，然后过渡到关注积极的图像。我们现在提出一项随机临床试验，评估 TAT 与常规护理对照组支持组相比对于维持减肥的主要结果的功效。我们将从社区和管理式医疗机构招募肥胖和超重的成年人。那些符合资格要求的人将被分配接受为期 20 周的强化小组行为减肥干预。大约 288 名在完成减肥部分后达到减肥阈值标准的患者将被随机分配到 TAT 指导组或辅助支持组对照组。两组患者将在 6 个月内参加总共 8 次小组会议，总共 13 个小时的接触时间，并且 TAT 组的患者将被建议在家练习该技术。参与者将在基线、随机分组时进行称重，然后在 3、6、9 和 12 个月时再次进行称重。还将在基线和一年的随访中进行问卷调查，以测量次要结果（生活质量和社会心理功能）和潜在的中介因素（饮食、身体活动、食物渴望、社会心理压力）。在拟议的试验中，减肥维持方面的统计显着改善可能表明将 TAT 作为传统护理环境中的标准减肥维持干预措施。这项研究与公共卫生的相关性是：超重和肥胖是可预防死亡的第二大原因，主要是通过对心血管疾病 (CVD) 危险因素和癌症的影响。尽管将体重控制作为高血压、高脂血症和 2 型糖尿病治疗指南的核心组成部分，但肥胖流行病仍在继续增长，影响了超过 1 亿美国人。