Log2Lose: Incenting weight loss and dietary self-monitoring in real-time to improve weight management

Log2Lose：激励减肥和实时饮食自我监控，以改善体重管理

基本信息

批准号：
10627319
负责人：
Corrine Ione Voils
金额：
$ 1.61万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
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：
2020-09-15 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10627319
关键词：
Address Adult Affect Algorithms American Behavior Behavior Therapy Behavioral Black race Body Weight decreased Cellular Phone Clinical Clinical Trials Communities Computer software County Data Data Analyses Diet Doctor of Philosophy Ethnic Origin Ethnic group First Generation College Students Future Goals Health Health behavior outcomes Healthcare Hispanic Hispanic Populations Incentives Individual Intervention Intervention Studies Joints Latino Latino Population Latinx Latinx population Maintenance Measures Mediating Medicine Mentorship Minority Monitor Not Hispanic or Latino Obesity Outcome Participant Patients Persons Phase Population Prevalence Process Program Effectiveness Quality of life Race Randomized Relationship-Building Research Research Activity Research Methodology Research Personnel Research Training Role Single-Blind Study Site Technology Testing Text Messaging Time Training Underrepresented Populations Universities Weight Weight maintenance regimen Wisconsin Work career clinically significant community engagement comorbidity cost cost effective cost effectiveness cost-effectiveness ratio design dietary effectiveness testing ethnic minority evidence base experience extrinsic motivation financial incentive four-arm study hands on research improved interest intervention cost intervention effect intrinsic motivation next generation parent grant payment primary endpoint program costs programs racial minority recruit training opportunity undergraduate student weight loss intervention weight loss program weight maintenance

项目摘要

Abstract In the past 40 years, the prevalence of obesity has increased at an alarming rate. Even modest weight loss of at least 5% improves clinical parameters and quality of life. Efficacious behavioral weight loss programs teach participants behavioral strategies to create and maintain a caloric deficit. The two strongest predictors of long- term weight loss in such programs are initial weight loss and dietary self-monitoring. Over time, these phenomena decline, limiting program effectiveness. Financial incentives to increase initial weight loss and self- monitoring are appealing because they can be delivered to large populations with relative ease and at low cost. Employers and payers have begun to provide financial incentives for health behaviors and outcomes despite an inadequate evidence base to inform the optimal design of such interventions. The proposed study will evaluate which incentive approach has the greatest impact and durability—incentivizing interim weight loss, dietary self-monitoring, or both. Studies testing the effects of incentivizing these phenomena have showed some promise for increasing short-term weight loss. Few studies have evaluated incentive effects on long-term weight loss; examined the mediating role of intrinsic or extrinsic motivation; or calculated program costs or cost-effectiveness of financial incentive interventions. In the proposed two-site, randomized, single-blinded, longitudinal 2x2 factorial study, known as “Log2Lose,” we address these limitations by evaluating the individual and joint effects of incentivizing, in near real-time, weekly weight loss and dietary self-monitoring on 6-month weight loss and subsequent weight loss maintenance. People with obesity from the communities of Madison, WI and Durham, NC will receive an 18-month intervention comprising: 1. An incentivized weight loss program for 6 months (Phase I), 2. An incentivized weight maintenance program for 6 months (Phase II), and 3. A non- incentivized weight maintenance program for 6 months (Phase III). Participants will be randomized to receive adjunctive incentives for weekly weight loss, dietary self-monitoring, both, or neither. We will measure the proportion of participants achieving clinically significant weight loss of ≥5% at 6 (primary endpoint), 12, and 18 months. We will assess whether extrinsic and intrinsic motivation mediate intervention effect; calculate intervention costs; and calculate cost-effectiveness ratios across the four study arms. Our financial incentives intervention was designed to be scalable by using available technology and automating the process of analyzing data to provide incentives in near real-time. The intervention could be paired with various weight loss interventions offered by clinicians or payers, or integrated into a variety of patient and consumer-facing technologies. Completion of this study will contribute to our long-term goal of identifying and implementing efficacious, cost-effective, scalable approaches to reduce the prevalence of obesity and associated health outcomes.

抽象的在过去的40年中，肥胖症的患病率以惊人的速度增加。甚至适度的体重减轻至少5％改善了临床参数和生活质量。有效的行为减肥计划教学参与者创建和维持热量防御的行为策略。长期的两个强烈预测指标此类程序中的定期体重减轻是最初的体重减轻和饮食自我监控。随着时间的流逝，这些现象下降，限制计划的有效性。增加初始体重减轻和自我的经济激励措施监视之所以出现，是因为它们可以相对轻松且价格低廉。雇主和付款人已开始为健康行为和成果目的地提供经济激励措施证据基础不足以告知此类干预措施的最佳设计。拟议的研究将评估哪种激励方法具有最大的影响和耐用性 - 使临时体重减轻，饮食自我监控，或两者兼而有之。测试激励这些现象的影响的研究表明有一些希望增加短期体重减轻的希望。很少有研究评估了对长期的激励作用减肥；研究了内在或外在动机的中介作用；或计算的计划费用或经济激励干预措施的成本效益。在拟议的两个站点，随机，单盲，纵向2x2阶乘研究，称为“ log2lose”，我们通过评估个体来解决这些局限性激励近乎实时的激励的共同影响，每周减肥和饮食自我监测6个月体重减轻和随后的减肥维持。麦迪逊社区肥胖的人， WI和北卡罗来纳州达勒姆市将获得18个月的干预完成：1。激励减肥计划 6个月（I阶段），第2个。激励体重维持计划6个月（II阶段）和3个。激励体重维持计划6个月（第三阶段）。参与者将被随机接收每周减肥，饮食自我监控，或两者都不是的辅助激励措施。我们将衡量在6（主要终点），12和18的参与者的比例临床上显着的体重减轻≥5％（主要终点）月份。我们将评估外在动机和内在动机是否介导了干预效果；计算干预费用；并计算四个研究组的成本效益比。我们的经济激励措施干预旨在通过使用可用技术并自动化的过程可扩展分析数据以实时提供激励措施。干预措施可以与各种减肥配对临床医生或付款人提供的干预措施，或融入各种患者和面向消费者技术。这项研究的完成将有助于我们确定和实施的长期目标有效，成本效益，可扩展的方法，以降低肥胖症的流行和相关健康结果。