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

项目摘要 在平均体重增加30磅的年轻人(YAS)中，体重增加的比例很高。正在发生 年龄在18-35岁之间，并与心血管疾病危险因素的早期恶化有关。初级预防 体重增加很重要，因为减肥很难实现，接受计划的机会有限，而且最初 随着时间的推移，成功人士的体重会逐渐增加。体重增加是国防部的一个严重问题，我们的 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 是的，肥胖率和每年的体重增加都在增加。许多人认为，年轻的现役男子 而且，由于军人的生活方式，女性健康、苗条、健康，不会肥胖。不幸的是， 美国现役军人的肥胖率反映了平民的肥胖率。此外，无法 保持健康的体重会导致过早退役，并威胁到训练有素的飞行员 已部署。军队中的超重现在被认为是对国家安全的威胁。体重几乎没有增加 预防(WGP)试验已经在军事人群中进行，之前的YAS试验喜忧参半 结果和较差的外部效度。我们的建议旨在解决以下主要公共卫生问题 在军队中增加体重，以及解决务实的mHealth和WGP试验中的显著差距。快照- 将与来自美国空军的合作伙伴和关键利益相关者一起，根据我们的证据进行干预- 基于WGP对YAS的干预，研究预防体重增加的新方法(SNAP)。折断 在599名普通人群中测试了两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 2)进行SNAP-M干预的语用混合类型1有效性试验 从4个军事机构招募的454名空军飞行员的2组随机对照试验 以平均体重从基线变化到2年为主要结果。我们将在关键字上比较这两个组 结果和检查潜在的调节治疗效果的因素。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潜力的框架， 如果成功，SNAP-M的实施和维护。这项拟议的研究填补了以下领域的关键研究空白 急需预防体重增加的服务不足的人群，完全适合远程分娩 对于军队里的亚斯来说。

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.