Food supplementation interventions to improve weight loss for adults with food insecurity and obesity

食品补充剂干预措施可改善粮食不安全和肥胖成年人的减肥效果

• 批准号: 10708130
• 负责人: ARIANA MARIE CHAO
• 金额: $ 14.96万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10708130
• 关键词: Address; Adherence; Adult; Affect; American; Behavior; Behavioral; Biological Markers; Body Weight decreased; Carotenoids; Chronic; Communities; Data; Diabetes Mellitus; Diet Habits; Disparity; Disparity population; Education; Ensure; Food; Food Supplementation; Fruit; Goals; Guidelines; Health; Health Personnel; Health behavior; Healthcare; Healthcare Systems; Healthy Eating; Home; Improve Access; Individual; Intervention; Knowledge; Measures; Meat; Medical; Mission; National Institute of Nursing Research; Neighborhoods; Nutritional; Obesity; Obesity Epidemic; Outcome; Outcome Study; Participant; Patient Self-Report; Patients; Persons; Provider; Randomized, Controlled Trials; Recommendation; Research; Resources; Secure; Skin; Testing; Thinness; Time; Transportation; United States Centers for Medicare and Medicaid Services; Vegetables; Weight; Weight maintenance regimen; adult obesity; barrier to care; clinical care; cost; design; dietary; energy density; food desert; food environment; food insecurity; food resource; fruits and vegetables; good diet; health difference; health equity; health related quality of life; improved; indexing; novel; nutrition; obese patients; obesity treatment; patient screening; prevent; programs; skills; social; social disparities; social health determinants; socioeconomic disparity; socioeconomics; standard of care; treatment adherence; voucher; weight loss intervention

PROJECT SUMMARY/ABSTRACT Food insecurity is common among people with obesity and is associated with suboptimal outcomes in behavioral weight loss (BWL) treatment. However, we do not yet have evidence of treatment approach to address food insecurity and obesity that can target multiple barriers including cost, access, skills, knowledge, and behavior. improving The overarching goal of this application is to reduce socioeconomic disparities in obesity by patients' abilities to afford and access nutritious foods during BWL treatment. To accomplish thisgoal, the proposed 3-group, parallel design, randomized controlled trial will assign 258 adults with obesity and food insecurity to BWL-Alone (including standard-of-care referral and connection with community food resources; delivered, vouchers provided of n=86); BWL plus food supplementation with either food vouchers (BWL+VOUCHER; n=86); home- medically tailored groceries consistent with BWL recommendations (BWL+HOME; n=86). Food and HOME will be provided for the first 24 weeks o treatment. All groups will have BWL treatment for 52 weeks per CMS guidelines. Assessments will be conducted at baseline, and weeks 12, 24 (end food supplementation), and 52 (end of BWL treatment). f Our aims are to test the hypothesis that BWL+VOUCHER and BWL+HOME will result in greater weight loss (percent of initial weight) at 24 weeks than BWL-Alone. A secondary aim is to determine if BWL+VOUCHER and BWL+HOME result in better weight loss at 52 weeks compared to BWL-Alone. Additional secondary aims are to examine treatment differences in health-related quality of life and self-reported and objective measures of dietary quality. The expected outcome of this study is to demonstrate feasible food support interventions that can be used within health care systems to address social determinants of health and achieve better health equity, and is well aligned to contribute to the mission of the National Institute of Nursing Research.

项目摘要/摘要 粮食不安全感在肥胖者中很普遍，并且与次优的结果有关 行为减肥（BWL）治疗。但是，我们尚无治疗方法的证据 解决粮食不安全和肥胖症，可以针对多个障碍，包括成本，获取，技能，知识， 和行为。 改进 此应用的总体目标是减少肥胖中的社会经济差异 在BWL治疗期间，患者能够负担和获得营养食品的能力。为了实现这一目标，拟议的3组平行设计，随机对照试验将分配258名肥胖症的成年人 对BWL-NORE的粮食不安全（包括护理标准的推荐和与社区食物的联系 资源; 发表， 代金券 假如 的 n = 86）; BWL加上任何食品凭证（BWL+代金券; n = 86）;家- 与BWL建议一致的医学量身定制的杂货（BWL+Home; n = 86）。食物 并将在最初的24周O治疗中提供房屋。所有组都将接受BWL治疗 每个CMS指南52周。评估将在基线和第12周，第24周进行（结束 补充食物）和52（BWL治疗结束）。 f 我们的目的是检验以下假设 BWL+代金券和BWL+房屋将在24周时导致重量减轻（初始体重的百分比） BWL-Olone。次要目的是确定BWL+代金券和BWL+家庭是否会导致体重减轻更好 与单独的BWL相比，在52周时。其他次要目的是检查治疗差异 与健康相关的生活质量以及自我报告和客观的饮食质量度量。预期的结果 这项研究的目的是证明可在医疗保健系统中使用的可行食物支持干预措施 解决健康的社会决定因素并实现更好的健康公平，并有很好的一致性 美国国家护理研究所的任务。