Preventing weight gain in U.S. Air Force personnel using a novel mobile health intervention

项目摘要 体重增加在年轻人（YAs）中不成比例，平均体重增加30磅。发生 年龄在18 - 35岁之间，与CVD危险因素的早期恶化有关。一级预防 体重增加很重要，因为减肥很难实现，进入程序是有限的，最初 成功人士体重会随着时间的推移而反弹。体重增加是国防部的一个严重问题， 它是美国最大的雇主，员工人数超过沃尔玛或亚马逊。军队主要由 YAs的肥胖率和每年的体重增加率都在上升。很多人认为年轻的现役军人 由于军人的生活方式，妇女身体健康，身材苗条，不容易肥胖。不幸的是， 美国现役军人的肥胖率与平民的肥胖率相似。此外，无法 保持健康的体重会导致过早出院，并威胁到训练有素的飞行员的准备工作， 部署。军队超重现在被认为是对国家安全的威胁。体重增加很少 预防（WGP）试验已经在军事人群中进行，以前的YAs试验混合了 结果和外部效度差。我们的建议旨在解决以下主要公共卫生问题： 在军队中的体重增加，以及解决务实的mHealth和WGP试验中的显着差距。SNAP- M干预措施将与美国空军的合作伙伴和主要利益相关者一起根据我们的证据进行调整- 基于WGP的YAs干预，新方法预防体重增加的研究（SNAP）。snap 在599名普通人群中测试了2种自我调节干预措施，发现两者都减少了体重增加， 与对照组相比，超过2 - 3年。该项目建议1）对SNAP进行关键调整，以促进 翻译和2）进行实用混合1型有效性试验的SNAP-M干预使用 2-在4个军事基地招募的454名空军飞行员中进行了随机对照试验（RCT）设计 主要结果为从基线到2年的平均体重变化。我们将比较各组的关键 结果，并检查治疗效果的潜在调节因素。此外，我们将应用RE-AIM 确定覆盖面和代表性以及组织一级采用的可能性的框架， 实施和维护SNAP-M，如果成功。拟议的研究填补了关键的研究空白， 急需通过完全远程交付预防体重增加的服务不足人群 在军队里的YA。

PROJECT ABSTRACT Weight gain is disproportionately high among young adults (YAs) with average weight gain of 30 lbs. occurring between ages 18-35 and is associated with an early worsening of CVD risk factors. Primary prevention of weight gain is important because weight loss is difficult to achieve, access to programs is limited, and initially successful people regain weight over time. Weight gain is a serious problem in the Department of Defense, our nation’s largest employer, with more employees than Walmart or Amazon. The military, comprised largely of YAs, has growing rates of obesity and yearly weight gain. Many people believe that young, active-duty men and women are fit, lean, and healthy because of the military lifestyle and protected from obesity. Unfortunately, obesity rates in active U.S. military personnel have mirrored those of civilians. Furthermore, inability to maintain a healthy weight results in early discharges and threatens the readiness of well-trained Airmen to be deployed. Overweight in the military is now considered a threat to national security. Few weight gain prevention (WGP) trials have been done in military populations, and previous trials with YAs have mixed results and poor external validity. Our proposal is designed to address the major public health problem of weight gain in the military, as well as address notable gaps in pragmatic mHealth and WGP trials. The SNAP- M intervention will be adapted, with partners and key stakeholder from the US Air Force, from our evidence- based WGP intervention for YAs, the Study of Novel Approaches to weight gain Prevention (SNAP). SNAP tested 2 self-regulatory interventions in 599 general population YAs and found that both reduced weight gain over 2-3 years compared to controls. This project proposes to make 1) critical adaptions to SNAP to facilitate translation and 2) conduct a Pragmatic Hybrid Type 1 Effectiveness Trial of the SNAP-M intervention using a 2-group randomized controlled trial (RCT) design in 454 Air Force Airmen recruited from 4 military installations with the primary outcome of mean weight change from baseline to 2 years. We will compare the groups on key outcomes and examine potential moderators of treatment effect. Additionally, we will apply a RE-AIM Framework to determine reach and representativeness, and potential for organizational-level adoption, implementation, and maintenance of SNAP-M, if successful. The proposed research fills key research gaps in an underserved population in critical need of weight gain prevention with completely remote delivery suitable for YAs in the military.