APP-ME: Addressing Place & People MicroEnvironments in weight loss disparities

APP-ME：地址地点

基本信息

批准号：
9103617
负责人：
DANIEL O CLARK
金额：
$ 63.55万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-02 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9103617
关键词：
Accelerometer Accounting Address Affect African American Age Awareness Back Behavior Bite Body Weight Changes Body Weight decreased Calories Cause of Death Cellular Phone Charge Conscious Cues Data Data Collection Decision Making Eating Eating Behavior Ecological momentary assessment Emotions Energy Metabolism Environment Exposure to Fatty acid glycerol esters Federally Qualified Health Center Food Goals Health Health system Healthy People 2010 Home environment Human Hybrids Hypertension Image Individual Intention Intervention Intervention Trial Lead Life Life Style Literature Location Measures Methods Mind Modeling Morbidity - disease rate Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Obesity Outcome Participant Persons Prevalence Provider Randomized Reporting Research Risk Risk Reduction Role Scientist Site Smell Perception Social Environment Social Interaction Social Network Social support Sodium Source Stimulus Stroke Testing Time Translating Weight Weight Gain Weight maintenance regimen Woman Work arm design disparities in morbidity experience fast food health disparity improved lifestyle intervention member middle age next generation novel novel strategies obesogenic programs public health relevance racial disparity randomized trial reconstruction research study response safety net sedentary activity sedentary lifestyle smoking cessation social tool treatment as usual weight loss intervention

项目摘要

DESCRIPTION (provided by applicant): Multi-site RCTs have shown that every 2lbs of weight loss is associated with a 20% reduction in the 3yr risk of hypertension and a 32% reduction in the 3yr risk of type 2 diabetes. This is equivalent to the stroke risk reduction associated with smoking cessation. Unfortunately, in intervention trials dating back to 1990, black women have experienced 50% less weight loss than white women. Thus, lifestyle weight loss interventions may actually increase racial disparities in morbidity; all 5 leading causes of death among black women are obesity-related. Obesity prevalence among the urban poor is very high and obesity research in the urban poor is an IOM and DHHS priority. Starting in 2006, we worked with the 3rd largest safety-net health system in the U.S. to implement a lifestyle weight loss intervention that operates in its 8 Federally Qualified Health Centers. This program too has resulted in 50% less weight loss in black relative to white women. We also have an ongoing weight loss RCT testing the impact of delivering the intervention into the homes of the urban poor. No outcomes are available yet but it too is a person-centric lifestyle intervention. With a goal of improving weight loss outcomes, we successfully piloted a novel approach to assessing micro- environments that coincide with weight-related behaviors including momentary social interactions and emotions. Literature places a very strong emphasis on the role of social micro-environments in obesity and weight loss disparities. Individuals are often unaware of the influence of micro-environments on their behavior. For example, experiments have shown that we consume up to 70% more calories when eating with others and that we are largely unaware we have done so. Previous research suggests social networks of black women are less supportive of weight loss than are those of white women. Such social networks may lead to more exposures to obesity, food, eating, sedentary activities, and acceptance of these. In fact, a recent year-long study that captured objective assessments of social interactions among first year dormitory residents found the number of interactions with weight gaining others accounted for 1/3rd of the variance in one-year weight gain. We seek in the proposed study to assess, compare, and test the influence of social and physical micro- environments and emotions on inactivity and eating in 300 urban poor black and white women. Our Aim 1 involves novel data collection via GPS, Bite Counters, and accelerometers to obtain location and behavior data and a hybrid of ecological momentary assessment and the day reconstruction method to obtain social interaction and emotion data. In our Aim 2 randomized trial, these data are used to test hypotheses about micro-environments and weight change. Each individual's Aim 1 data are used to test whether messages in the form of health-related words and images at the time and location each woman's data indicate she is vulnerable to eating or sedentary activity affect weight change. This work will inform next-generation weight loss programs and advance our understanding of automatic behaviors in health and health disparities.

描述（由适用提供）：多站点的RCT表明，每2磅体重减轻的人数与3岁的高血压风险降低了20％，而3岁的2型糖尿病风险降低了32％。这相当于与戒烟有关的降低中风风险。不幸的是，在可以追溯到1990年的干预试验中，黑人妇女的体重减轻比白人妇女少50％。这是生活方式减肥干预措施实际上可能会增加发病率的种族分布。黑人妇女中的所有5种主要死亡原因都是与肥胖有关的。城市贫困人口的肥胖症患病率很高，城市贫困人口的肥胖研究是IOM和DHHS的优先事项。从2006年开始，我们与美国第三大安全网卫生系统合作，实施了在其8个联邦合格的医疗中心运作的生活方式减肥干预措施。相对于白人女性，该计划也导致黑人体重减轻减少了50％。我们还进行了持续的减肥RCT测试，将干预措施交付到城市贫困人口的房屋中的影响。目前尚无结果，但这也是以人为本的生活方式干预。为了改善体重减轻结果，我们成功地试行了一种新的方法来评估与体重相关行为（包括瞬时社交互动和情感）的微环境。文学非常重视社会微环境在肥胖和减肥分布中的作用。个人通常不知道微环境对其行为的影响。例如，实验表明，与他人一起吃饭时，我们消耗多达70％的卡路里，而我们在很大程度上并不意识到我们已经这样做了。先前的研究表明，黑人妇女的社交网络比白人妇女的体重减轻少。这样的社交网络可能会导致更多接触肥胖，食物，饮食，久坐的活动以及对这些活动的接受。实际上，最近一年的一项研究捕获了对第一年宿舍居民之间社会互动的客观评估，发现与体重增加的相互作用数量是一年体重增加的差异的1/3。我们在拟议的研究中寻求评估，比较和测试社会和物理微环境以及情绪对300名城市贫困黑白妇女的不活动和进食的影响。我们的目标1涉及通过GP，咬合计数器和加速度计的新数据收集，以获取位置和行为数据，以及生态瞬时评估的混合以及一天的重建方法，以获得社交互动和情感。在我们的目标2随机试验中，这些数据用于测试有关微环境和重量变化的假设。每个人的目标1数据用于测试以健康相关的单词和图像形式的消息，每个妇女的数据表明她容易饮食或久坐活动会影响体重的变化。这项工作将为下一代减肥计划提供信息，并促进我们对健康和健康分配中自动行为的理解。