Weight gain prevention among black women in the rural community health center setting: The Shape Program
Weight gain prevention among black women in the rural community health center setting: The Shape Program
复制标题
DOI：
10.1186/1471-2458-12-305
复制
发表时间：
2012-04-26
影响因子：
4.5
通讯作者：
Bennett, Gary
中科院分区：
文献类型：
--
作者：
Foley, Perry;Levine, Erica;Bennett, Gary
背景：近60%的黑人女性肥胖。尽管黑人妇女患肥胖症和相关慢性病的风险增加，但在减肥干预措施的临床试验中，特别是在初级保健环境中进行的试验中，黑人妇女的代表性不足。此外，现有的肥胖治疗对这一人群的效果较差。促进体重维持可以在比减肥更低的治疗强度下实现，并有望降低肥胖相关慢性疾病的风险。体重增加的预防也可能是更符合肥胖相关的社会文化的黑人women.Methods/设计的观点比传统的减肥approaches：我们进行了一项为期18个月的随机对照试验（形状程序）的体重增加的预防干预超重的黑人女性患者在初级保健设置。参与者包括194名绝经前黑人女性，年龄在25至44岁之间，BMI为25-34.9 kg/m（2）。参与者被随机分配到常规护理或12个月的干预，包括：定制的致肥胖行为改变目标，通过交互式语音应答电话进行自我监测，定制的技能培训材料，与注册营养师和12个月的YMCA会员进行12次咨询电话。参与者被随访超过18个月，在基线、6个月、12个月和18个月进行研究访问。在每次访视时收集人体测量数据、血压、空腹血脂、空腹血糖和自我管理调查。在基线和12个月时收集加速度计数据。基线时，参与者平均年龄为35.4岁，平均体重指数为30.2 kg/m2。参与者大多是就业和低收入者。几乎一半的样本报告了高血压或高血压前期的诊断，12%报告了糖尿病或糖尿病前期的诊断。几乎三分之一的参与者吸烟，超过20%的得分高于临床阈值为depression.Discussion：形状程序利用创新的干预方法，以降低风险的肥胖和肥胖相关的慢性疾病的黑人妇女在初级保健设置。该干预措施以行为改变理论为依据，旨在使用廉价的移动的技术和现有的健康中心资源来防止体重增加。基线特征反映了需要循证治疗策略的社会经济弱势、高危人群样本。
Background: Nearly 60% of black women are obese. Despite their increased risk of obesity and associated chronic diseases, black women have been underrepresented in clinical trials of weight loss interventions, particularly those conducted in the primary care setting. Further, existing obesity treatments are less effective for this population. The promotion of weight maintenance can be achieved at lower treatment intensity than can weight loss and holds promise in reducing obesity-associated chronic disease risk. Weight gain prevention may also be more consistent with the obesity-related sociocultural perspectives of black women than are traditional weight loss approaches.Methods/Design: We conducted an 18-month randomized controlled trial (the Shape Program) of a weight gain prevention intervention for overweight black female patients in the primary care setting. Participants include 194 premenopausal black women aged 25 to 44 years with a BMI of 25-34.9 kg/m(2). Participants were randomized either to usual care or to a 12-month intervention that consisted of: tailored obesogenic behavior change goals, self-monitoring via interactive voice response phone calls, tailored skills training materials, 12 counseling calls with a registered dietitian and a 12-month YMCA membership. Participants are followed over 18 months, with study visits at baseline, 6-, 12- and 18-months. Anthropometric data, blood pressure, fasting lipids, fasting glucose, and self-administered surveys are collected at each visit. Accelerometer data is collected at baseline and 12-months. At baseline, participants were an average of 35.4 years old with a mean body mass index of 30.2 kg/m(2). Participants were mostly employed and low-income. Almost half of the sample reported a diagnosis of hypertension or prehypertension and 12% reported a diagnosis of diabetes or prediabetes. Almost one-third of participants smoked and over 20% scored above the clinical threshold for depression.Discussion: The Shape Program utilizes an innovative intervention approach to lower the risk of obesity and obesity-associated chronic disease among black women in the primary care setting. The intervention was informed by behavior change theory and aims to prevent weight gain using inexpensive mobile technologies and existing health center resources. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk population sample in need of evidence-based treatment strategies.