Project TEAMS (Talking about Eating, Activity, and Mutual Support): a randomized controlled trial of a theory-based weight loss program for couples
Project TEAMS (Talking about Eating, Activity, and Mutual Support): a randomized controlled trial of a theory-based weight loss program for couples
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DOI：
10.1186/s12889-017-4732-7
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发表时间：
2017-09-29
影响因子：
4.5
通讯作者：
Medina, Tania Huedo
中科院分区：
文献类型：
--
作者：
Gorin, Amy A.;Powers, Theodore A.;Medina, Tania Huedo
背景：肥胖的风险是夫妻双方共同承担的，然而现有的减肥计划关注的是个人，而不是夫妻双方。考虑到夫妻之间体重的相互依赖性，通过针对联合减肥和创造支持长期行为改变的人际环境，体重管理结果可能会得到改善。根据自我决定理论（SDT），更大的自主自我调节的行为，并随后更好的治疗效果，观察到在需要支持的环境中，个人有意义的选择得到支持，批评和控制最小化。相关性分析证实了这些途径在体重管理，需要支持一个人的配偶或合作伙伴出现作为一个独特的预测减肥成功。现在需要研究建立因果关系，并制定和测试减肥干预措施，旨在促进配偶的需要支持的行为。方法：项目团队（谈论饮食，活动和相互支持）是一项随机对照试验，测试基于SDT的夫妇干预，旨在通过训练配偶为彼此的饮食和体育活动行为提供需求支持来改变减肥的社会背景。64对夫妇将随机接受6个月的SDT告知的行为减肥治疗（SDT-WL）或6个月的标准行为减肥治疗（BWL）。夫妇将参加为期6个月的每周会议，并将在0，3，6和12个月进行评估。通过加强需求支持，SDT-WL预计将增加自主的自我调节和感知能力，并产生更大的减肥和维持比标准的行为治疗。探索性分析将研究SDT过程模型预测的需要支持治疗结果的影响将介导的自主自我调节和感知capability.Discussion：本研究旨在解决人际支持的根本重要性，在体重管理的重点是夫妇，而不是个人，并使用丰富的理论框架，以训练配偶的支持行为。
Background: Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT), greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one's spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses.Methods: Project TEAMS (Talking about Eating, Activity, and Mutual Support) is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other's eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL) or to 6 months of standard behavioral weight loss treatment (BWL). Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence.Discussion: This study addresses the fundamental importance of interpersonal support in weight management by focusing on couples rather than individuals and using a rich theoretical framework to train spouses in supportive behaviors.