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：
10602476
负责人：
Gareth R Dutton
金额：
$ 49.07万
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 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10602476
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 Economics Educational Materials Electronics Exercise Feedback Fostering Guidelines Harm Reduction Health Individual Informal Social Control Instruction Intervention Monitor Obesity Observational Study Patients Persons Practice Management Prevalence Prevention Primary 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 clinical care cost effective cost-effectiveness evaluation dietary digital effective therapy excessive weight gain multi-component intervention obese patients obesity management participant enrollment prevent primary care patient primary care provider primary outcome research to practice routine care screening secondary outcome standard care theories web-enabled weight gain prevention young adult

Accountability Adherence Adoption Adverse effects Affect Alabama Attenuated Awareness Behavior Blood Glucose Blood Pressure Body Weight decreased Body mass index Calories Caring Clinical Data Economics Educational Materials Electronics Exercise Feedback Fostering Guidelines Harm Reduction Health Individual Informal Social Control Instruction Intervention Monitor Obesity Observational Study Patients Persons Practice Management Prevalence Prevention Primary 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 clinical care cost effective cost-effectiveness evaluation dietary digital effective therapy excessive weight gain multi-component intervention obese patients obesity management participant enrollment prevent primary care patient primary care provider primary outcome research to practice routine care screening secondary outcome standard care theories web-enabled weight gain prevention young adult

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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.

项目摘要/摘要大多数肥胖症成年人继续增加体重。虽然初级保健临床指南建议提供肥胖症患者的强化体重管理治疗方法或转介有严重的障碍交付。即使提供，许多患者也没有时间或资源参加。鉴于此，在减肥和减轻体重的挑战中，减少伤害框架的重点是破坏肥胖症患者的持续与年龄有关的体重增加可能是减轻的策略肥胖的不良健康影响。自我调节理论表明，每日自我差异（DSW；即指示每天体重和监控体重）提供了一种简单的方法来促进患者的体重管理肥胖。我们和其他人已经表明，DSW同事的体重管理更好，可能是理想的对于初级保健，由于其低负担和与临床指南的一致性，建议自我监测健康参数，例如血压和葡萄糖。但是，DSW的效果在肥胖成年人中在初级保健中实施的是未知的。因此，我们建议进行挥杆（初级保健中肥胖管理的每日自我差异），24个月的随机对照试验（RCT）在400名肥胖成年人中（即体重指数[BMI]：kg/m2≥30）通过A接受初级保健伯明翰（UAB）的阿拉巴马大学的临床网络分支机构。注册的参与者将收到体重管理教育材料，然后随机分配给DSW或标准护理（SC）。 DSW会涉及提供具有图形重量反馈的网络功能量表，而SC将涉及常规关心。我们将测试分配给DSW对体重（主要结果）和自我启动的因果关系在24个月内采用体重管理实践（次要结果）（AIM 1）。我们还将测试 DSW依从性对体重和体重控制实践的因果影响（AIM 2）。最后，我们将评估与SC相比，DSW的成本有效性（AIM 3）。结果将使我们能够估计DSW是否减轻肥胖的成年人的持续与年龄相关的体重增加。如果是这样，DSW可能会拥有大量的公共卫生和经济影响通过提供一种可以在初级保健中实施的体重管理策略。