Development of a Web-Based, Guided Self-help, Acceptance and Commitment Therapy-Based Intervention for Weight Loss Maintenance: Evidence-, Theory-, and Person-Based Approach.
Development of a Web-Based, Guided Self-help, Acceptance and Commitment Therapy-Based Intervention for Weight Loss Maintenance: Evidence-, Theory-, and Person-Based Approach.
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开发一个基于网络的，引导自助，接受和承诺的减肥维持治疗为基础的干预：证据，理论和个人为基础的方法。
DOI：
10.2196/31801
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发表时间：
2022-01-07
影响因子：
2.2
通讯作者：
Ahern AL
中科院分区：
文献类型：
--
作者：
Richards R;Jones RA;Whittle F;Hughes CA;Hill AJ;Lawlor ER;Bostock J;Bates S;Breeze PR;Brennan A;Thomas CV;Stubbings M;Woolston J;Griffin SJ;Ahern AL
体重管理项目的长期影响和成本效益取决于治疗后的体重维持情况。越来越多的证据表明，基于第三波认知行为疗法，特别是接纳与承诺疗法（ACT）的干预措施可以改善长期体重管理；然而，这些干预措施通常由心理学家面对面提供，这限制了此类干预措施的可扩展性。
本研究的目的是采用基于证据、理论和个人的方法，开发一种基于ACT的维持减肥效果的干预措施，该措施利用数字技术和非专业人员的指导，以尽量减少大规模实施所需的资源。
干预措施的开发以医学研究理事会关于医疗保健中复杂干预措施开发的框架、干预措施规划方案以及一种提高干预措施可接受性和可行性的基于个人的方法为指导。工作分两个阶段进行：第一阶段包括整理和分析现有及新的主要证据，第二阶段包括理论建模和干预措施开发。第一阶段包括对以往研究中有关维持减肥效果的现有证据进行综合，对用于体重管理的第三波认知行为疗法干预措施进行系统综述和网络荟萃分析，对维持减肥效果的经历进行定性访谈研究，以及对维持减肥项目的合理成本进行建模。第二阶段包括指导原则的迭代开发、逻辑模型以及干预措施的设计和内容。建立了目标用户和利益相关者小组，为开发的每个阶段提供信息，并对原型干预措施的连续迭代进行用户测试。
这一过程产生了一种名为SWiM（支持体重管理）的基于ACT的引导式自助干预措施。SWiM是一个为期4个月的项目，包括连续13周每周一次的网络课程，之后参与者有4周的休息时间来反思和练习他们的新技能，第18周有最后一次课程。每次课程都包括心理教育内容、反思练习和行为实验。SWiM包括关于维持减肥效果的关键决定因素的特定课程，例如培养应对失误高风险情况的技能、养成新的有益习惯、打破旧的无益习惯，以及学习处理人际关系及其对体重管理的影响。一名受过训练的非专业教练通过该项目为参与者提供指导，安排4次30分钟的电话通话，并可另外提供3次可选通话。
这种综合方法促进了一种干预措施的开发，该措施基于支持人们维持减肥效果的科学理论和证据，并以目标用户的经验以及其预期实施的环境为基础。该干预措施将根据一项计划中的试点随机对照试验的结果进行完善。
The long-term impact and cost-effectiveness of weight management programs depend on posttreatment weight maintenance. There is growing evidence that interventions based on third-wave cognitive behavioral therapy, particularly acceptance and commitment therapy (ACT), could improve long-term weight management; however, these interventions are typically delivered face-to-face by psychologists, which limits the scalability of these types of intervention. The aim of this study is to use an evidence-, theory-, and person-based approach to develop an ACT-based intervention for weight loss maintenance that uses digital technology and nonspecialist guidance to minimize the resources needed for delivery at scale. Intervention development was guided by the Medical Research Council framework for the development of complex interventions in health care, Intervention Mapping Protocol, and a person-based approach for enhancing the acceptability and feasibility of interventions. Work was conducted in two phases: phase 1 consisted of collating and analyzing existing and new primary evidence and phase 2 consisted of theoretical modeling and intervention development. Phase 1 included a synthesis of existing evidence on weight loss maintenance from previous research, a systematic review and network meta-analysis of third-wave cognitive behavioral therapy interventions for weight management, a qualitative interview study of experiences of weight loss maintenance, and the modeling of a justifiable cost for a weight loss maintenance program. Phase 2 included the iterative development of guiding principles, a logic model, and the intervention design and content. Target user and stakeholder panels were established to inform each phase of development, and user testing of successive iterations of the prototype intervention was conducted. This process resulted in a guided self-help ACT-based intervention called SWiM (Supporting Weight Management). SWiM is a 4-month program consisting of weekly web-based sessions for 13 consecutive weeks followed by a 4-week break for participants to reflect and practice their new skills and a final session at week 18. Each session consists of psychoeducational content, reflective exercises, and behavioral experiments. SWiM includes specific sessions on key determinants of weight loss maintenance, including developing skills to manage high-risk situations for lapses, creating new helpful habits, breaking old unhelpful habits, and learning to manage interpersonal relationships and their impact on weight management. A trained, nonspecialist coach provides guidance for the participants through the program with 4 scheduled 30-minute telephone calls and 3 further optional calls. This comprehensive approach facilitated the development of an intervention that is based on scientific theory and evidence for supporting people with weight loss maintenance and is grounded in the experiences of the target users and the context in which it is intended to be delivered. The intervention will be refined based on the findings of a planned pilot randomized controlled trial.
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DOI：
10.1136/bmj.g2646
发表时间：
2014-05-14
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Dombrowski SU;Knittle K;Avenell A;Araújo-Soares V;Sniehotta FF
通讯作者：
Sniehotta FF
影响因子：
9.8
作者：
Kwasnicka D;Dombrowski SU;White M;Sniehotta F
通讯作者：
Sniehotta F
影响因子：
7.9
作者：
Armitage, Christopher J.;Conner, Mark;Epton, Tracy
通讯作者：
Epton, Tracy
影响因子：
1.7
作者：
Boucher S;Edwards O;Gray A;Nada-Raja S;Lillis J;Tylka TL;Horwath CC
通讯作者：
Horwath CC
DOI：
10.1016/j.jbtep.2018.06.010
发表时间：
2018-12-01
影响因子：
1.8
作者：
Abrahamsson, N.;Ahlund, L.;Alfonsson, S.
通讯作者：
Alfonsson, S.