Preventing weight gain among those who decline behavioral weight loss treatment

防止拒绝行为减肥治疗的人体重增加

基本信息

批准号：
10064248
负责人：
Megan Apperson McVay
金额：
$ 7.63万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-15 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10064248
关键词：
Address Adult Affect American Behavior Behavioral Body Weight decreased Calories Characteristics Clinical Trials Communities Data Diet Disease Effectiveness Electronic Health Record Empirical Research Enrollment Evidence based intervention Feedback Funding Group Meetings Guidelines Healthcare Systems Individual Intake Intervention Measurement National Heart, Lung, and Blood Institute Obesity Outcome Overweight Participant Patient Care Patients Persons Physical activity Pilot Projects Population Pragmatic clinical trial Premature Mortality Preventive Intervention Primary Health Care Public Health Randomized Controlled Trials Research Resources Risk Self Efficacy Specific qualifier value Testing Text Messaging Time Weight Weight Gain Weight maintenance regimen adult obesity arm base comorbidity cost design effectiveness testing evidence base experience feasibility trial health care settings high risk meetings obesity treatment prevent programs satisfaction skills success tailored messaging theories therapy design treatment guidelines trial design weight gain prevention

项目摘要

PROJECT SUMMARY/ABSTRACT Obesity treatment guidelines recommend comprehensive behavioral weight loss treatments as the first line approach for adults with either obesity or overweight with a weight-related comorbidity. However, the vast majority of adults who are eligible for these weight loss treatments do not initiate them, even when offered at no cost. For individuals who decline weight loss treatment, obesity guidelines suggest a focus on weight gain prevention. Unfortunately, existing interventions to prevent weight gain have the same characteristics that cause many individuals to reject weight-loss treatments in the first place, such as didactic-focused meetings and prescriptions for dietary and physical activity change. To prevent weight gain while overcoming these common barriers to engaging in weight management interventions, we propose an intervention that prescribes self-weighing but does not prescribe changes in diet or physical activity behaviors or require attendance at didactic-focused meetings. The potential of self-weighing to promote weight management is supported both by self-regulatory theory and empirical research. Promoting self-weighing may activate participants’ self- regulatory skills, leading to spontaneous decisions to reduce calorie intake or increase physical activity, thus preventing further weight gain. The proposed intervention will also provide individuals with text message-based feedback to promote continued self-weighing and to motivate engagement with evidence-based resources for weight management at a time when they may be more open to using these resources—e.g., after experiencing a small weight gain. The current proposal will investigate the feasibility and acceptability of this low burden self-weighing intervention in order to prepare for a fully-powered, pragmatic randomized controlled trial. We will enroll 60 primary care patients with either obesity or overweight with a weight-related comorbidity and who have declined to participate in a comprehensive behavioral weight management program. Participants will be asked to weigh themselves daily via a “smart” scale that transmits weight data directly to the study team via the cellular network. Every-other week, participants will be sent text messages providing brief feedback encouraging continued self-weighing. Moreover, if a small weight gain is observed, participants will be sent text messages aiming to engage them in commercial or community-based evidence-based weight management resources. In a single-arm design, all enrolled participants will receive the intervention for 12 months and will complete assessments at 3 and 12 months to assess feasibility and acceptability of the intervention and trial design, while weight will be obtained from participants’ Electronic Health Records (EHR). We will evaluate our success in meeting pre-specified metrics for trial feasibility and intervention acceptability outcomes, including intervention enrollment, intervention satisfaction, and obtainment of weight data abstracted from participants’ EHRs. We will also evaluate the success of the intervention in promoting regular self-weighing and use of evidence-based weight management resources.

项目摘要/摘要肥胖治疗指南建议全面的行为减肥治疗作为第一行肥胖或超重成年人的合并症的方法。但是，广大有资格获得这些减肥治疗的大多数成年人也不会发起它们，即使在无费用。对于拒绝减肥治疗的个人，肥胖指南建议专注于体重增加预防。不幸的是，现有的防止体重增加的干预措施具有与首先导致许多人拒绝减肥治疗，例如以教学为中心的会议和饮食和体育锻炼的处方变化。在克服这些方面，请防止体重增加参与体重管理干预措施的常见障碍，我们提出一种干预措施自我提高，但没有规定饮食或体育锻炼行为的变化或需要参加以教义为重点的会议。同时支持促进体重管理的潜力自我调节理论和实证研究。促进自我降低可能会激活参与者的自我监管技能，导致赞助商制定决策，以减少卡路里摄入量或增加体育锻炼，从而防止进一步的体重增加。拟议的干预措施还将为个人提供基于文本的消息反馈以促进持续的自我差异，并激励参与基于证据的资源体重管理在经历后可能更愿意使用这些资源的时候体重增加小。当前的提案将调查这种低燃烧的可行性和可接受性自我提高的干预措施，以准备一项完全动力的务实的随机对照试验。我们将注册60名肥胖症或超重的初级保健患者，并具有与体重相关的合并症以及谁拒绝参加一项全面的行为体重管理计划。参与者会被要求每天通过“智能”量表加权，该量表将权重数据直接传递给研究团队蜂窝网络。每周一次，参与者将收到短信，提供简短的反馈鼓励持续的自我提高。此外，如果观察到体重增加的少量，参与者将被发送文本消息旨在使他们参与基于商业或社区的基于社区的循证体重管理资源。在单臂设计中，所有注册的参与者将接受12个月的干预措施，并将在3个月和12个月时完成评估的可行性和可接受性和审判的可接受性设计，而重量将从参与者的电子健康记录（EHR）中获得。我们将评估我们的成功满足预先指定的指标，以实现可行性和干预可接受性结果，包括干预注册，干预满意度以及从参与者中提取的体重数据获得 ehrs。我们还将评估干预措施在促进定期自我差异和使用方面的成功基于证据的体重管理资源。