Small Incentives Improve Weight Loss in Women From Disadvantaged Backgrounds.
Small Incentives Improve Weight Loss in Women From Disadvantaged Backgrounds.
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DOI：
10.1016/j.amepre.2017.11.007
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发表时间：
2018-03
影响因子：
5.5
通讯作者：
Wing RR
中科院分区：
文献类型：
--
作者：
Leahey TM;LaRose JG;Mitchell MS;Gilder CM;Wing RR
来自低收入背景的女性肥胖率最高。因此，迫切需要针对这些高危人群的有效方案。有证据表明，在治疗中增加经济激励有助于参与和促进低收入人群的健康行为改变;然而，这从未在女性肥胖治疗中进行过测试。本研究的目的是检查是否增加小的财政奖励，以互联网减肥治疗产生更好的减肥结果，从低收入背景的妇女相比，相同的治疗没有奖励。低收入和高收入妇女的体重减轻情况也进行了比较。数据来自两项随机试验，其中女性（N=264）接受互联网行为减肥治疗（IBWL）或IBWL+奖励（IBWL+$）。客观评估体重。数据收集和分析时间为2011年至2017年。来自低收入背景的女性在IBWL+$中的减肥效果显著优于单独IBWL（6.4 [SD=4.9%] vs 2.6 [SD=4.6%]，p=0.01）。此外，IBWL+$组体重减轻≥5%的百分比高于IBWL单药组（52.6% vs 38.1%，p=0.01）。有趣的是，低收入组与高收入组之间的比较显示，仅在IBWL中，低收入女性的体重减轻明显较差（3.4 [SD=4.2%] vs 4.9 [SD=4.0%]，p=0.03）。相比之下，在IBWL+$中，体重减轻的结果没有因收入状况而异（5.0 [SD=5.6%] vs 5.3 [SD=3.8%]，p=0.80），低收入与高收入女性的体重减轻≥5%的比例相似（52.6% vs 53.8%，p=0.93）。互联网行为减肥计划加上经济激励措施可能是一种有效的策略，以促进低收入妇女的体重减轻，从而提高弱势，高风险人群的治疗结果的公平性。这些数据还提供了重要证据，支持联邦政府资助的针对低收入、服务不足人口的激励举措。
Women from lower-income backgrounds have the highest rates of obesity. Thus, effective programs for this high-risk population are urgently needed. Evidence suggests that adding financial incentives to treatment helps to engage and promote health behavior change in lower-income populations; however, this has never been tested in women for obesity treatment. The purpose of this study was to examine whether adding small financial incentives to Internet weight loss treatment yields better weight loss outcomes in women from lower-income backgrounds compared with the same treatment without incentives. Weight losses in lower versus higher income women were also compared. Data were pooled from two randomized trials in which women (N=264) received either Internet behavioral weight loss treatment (IBWL) or IBWL plus incentives (IBWL+$). Weight was objectively assessed. Data were collected and analyzed from 2011 to 2017. Women from lower-income backgrounds had significantly better weight loss outcomes in IBWL+$ compared with IBWL alone (6.4 [SD=4.9%] vs 2.6 [SD=4.6%], p=0.01). Moreover, a greater percentage achieved a ≥5% weight loss in IBWL+$ vs IBWL alone (52.6% vs 38.1%, p=0.01). Interestingly, the comparison between lower-income versus higher-income groups showed that, in IBWL alone, women with lower income achieved significantly poorer weight losses (3.4 [SD=4.2%] vs 4.9 [SD=4.0%], p=0.03). By contrast, in IBWL+$, weight loss outcomes did not differ by income status (5.0 [SD=5.6%] vs 5.3 [SD=3.8%], p=0.80), and a similar percentage of lower-versus higher-income women achieved a ≥5% weight loss (52.6% vs 53.8%, p=0.93). An Internet behavioral weight loss program plus financial incentives may be an effective strategy to promote excellent weight losses in women with lower income, thereby enhancing equity in treatment outcomes in a vulnerable, high-risk population. These data also provide important evidence to support federally funded incentive initiatives for lower-income, underserved populations.
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