Sleep GOALS - An Internet-Assisted Diet, Physical Activity, and Sleep Weight Loss Intervention for Postpartum Women

产后体重保留（PWR）是育龄妇女肥胖的重要原因。PWR 与体重的持续增加、以后的肥胖发展和心血管疾病有关 发展（CVD）。在产后妇女中，标准的减肥干预，解决饮食和 体力活动只产生了适度的效果。先前的干预措施受到限制， 解决睡眠不佳，产后妇女的常见问题。尽管有流行病学证据表明 睡眠和肥胖之间的关系，标准的减肥干预措施很少包括睡眠的关键因素 干预措施。将睡眠干预与饮食和体育活动相结合可能会促进体重减轻， 产后妇女本K 01的总体目标是开发和测试 睡眠目标的初步疗效（目标为重点的生活方式支持在线访问），一个互联网辅助 产后妇女的多种健康行为（饮食、体力活动和睡眠）减肥干预。我们 我将通过调整和整合现有的睡眠干预（TSC;跨诊断睡眠）来创建睡眠目标 和昼夜节律干预）与饮食和体力活动减肥干预（目标生活方式， 糖尿病预防计划的在线版本）。我们将使用干预映射来指导3步 适应过程。首先，我们将进行半结构化的访谈，有目的的样本12 产后3 - 6个月超重或肥胖的产妇审查框架 以及TSC和GOALS生活方式的内容，征求他们的建议，以调整这些干预措施， 产后妇女第二步：我们将通过审查拟议的改编来预先测试干预内容 相同的参与者。第三步：我们将使用参与者和行为睡眠专家的反馈 药物，减肥干预和行为改变，以确保适应保持核心 这些措施将有助于消除最初干预措施的要素，并解决产后妇女的具体需求。(Aim 1）。我们将 然后将40名产后妇女随机分为睡眠目标组或教育对照组，以测试其可行性， 可接受性和睡眠目标的初步疗效（目标2）。我们将利用试点试验的结果， 进行一项更大的、确定性的随机对照试验。多学科专家团队将指导 我在干预发展方面的训练，学习行为改变的科学， 干预开发和适应，以及以用户为中心的设计原则; 2）行为睡眠 医学，学习评估睡眠问题和制定个人睡眠管理计划;以及3） 随机对照试验，以学习进行临床试验研究的最佳实践。一致 根据NHLBI的战略目标和目的，这次培训将使我成为一名独立的 开发/调整针对多种健康行为的行为健康干预措施以减少 女性在产后期间的CVD风险。

Postpartum weight retention (PWR) is a significant contributor to obesity in women of reproductive age. PWR is associated with continued weight gain, obesity development later in life, and cardiovascular disease development (CVD). Among postpartum women, standard weight-loss interventions that address diet and physical activity have produced only modest effects. Prior interventions are limited by not adequately addressing poor sleep, a common issue in postpartum women. Despite epidemiological evidence on the relationship between sleep and obesity, standard weight-loss interventions rarely include key elements of sleep interventions. Integrating sleep interventions with diet and physical activity may enhance weight loss among postpartum women. The overall goal of this K01 is to develop and test the feasibility, acceptability, and preliminary efficacy of Sleep GOALS (Goal-focused Online Access to Lifestyle Support), an Internet-assisted multiple health behavior (diet, physical activity, and sleep) weight loss intervention for postpartum women. We will create Sleep GOALS by adapting and integrating an existing sleep intervention (TSC; Transdiagnostic Sleep and Circadian intervention) with a diet and physical activity weight-loss intervention (GOALS Lifestyles, an online version of the Diabetes Prevention Program). We will use intervention mapping to guide the 3-step adaptation process. First, we will conduct semi-structured interviews with a purposive sample of 12 primiparous women between 3 and 6 months postpartum with overweight or obesity to review the framework and content of TSC and GOALS Lifestyle to solicit their suggestions for adapting these interventions for postpartum women. Step 2: We will pre-test the intervention content by reviewing the proposed adaptations with the same participants. Step 3: We will use feedback from the participants and experts in behavioral sleep medicine, weight loss interventions, and behavior change to ensure the adaptations maintain the core elements of the original interventions and address the specific needs of postpartum women. (Aim 1). We will then randomize 40 postpartum women to Sleep GOALS or an education control group to test the feasibility, acceptability, and preliminary efficacy of Sleep GOALS (Aim 2). We will use the pilot trial results to inform the conduct of a larger and definitive randomized controlled trial. A multi-disciplinary team of experts will guide my training in 1) intervention development, to learn the science of behavioral change, frameworks for intervention development and adaptation, and principles of user-centered design; 2) behavioral sleep medicine, to learn to evaluate sleep problems and developing individual sleep management plans; and 3) randomized controlled trials to learn the best practices of conducting clinical trials research. Consistent with the NHLBI’s Strategic Goals and Objectives, this training will allow me to become an independent researcher who develops/adapts behavioral health interventions that target multiple health behaviors to reduce CVD risk in women during the postpartum period.