Obesity stigma and health behavior: An experimental approach

肥胖耻辱和健康行为：实验方法

• 批准号: 10434919
• 负责人: A. Janet Tomiyama
• 金额: $ 43.39万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10434919
• 关键词: Adult; American; Anxiety; Attitude; Behavior; Behavioral; Binge Eating; Body mass index; COVID-19; COVID-19 pandemic; Calories; Cardiovascular Diseases; Censuses; Data; Diet; Diet Records; Discrimination; Eating; Ecological momentary assessment; Etiology; Exercise; Experimental Designs; Food; Future; Goals; Health; Health behavior; Health behavior change; Healthcare; Hour; Human; Individual; Intake; Intervention; Knowledge; Life; Literature; Measures; Mental Depression; Nature; Obesity; Outcome; Overweight; Participant; Patient Self-Report; Persons; Physical activity; Population; Prejudice; Process; Public Health; Randomized; Research; Risk; Risk Behaviors; Risk Factors; Sleep; Sleep disturbances; Societies; Source; Stigmatization; Strenuous Exercise; Stress and Coping; Testing; Time; Unhealthy Diet; Weight; Work; actigraphy; allostatic load; base; demographics; diet and exercise; experience; experimental study; improved; laboratory experiment; mortality; obesity risk; obesogenic; pandemic disease; physical inactivity; poor sleep; preventable death; programs; resilience; social stigma; theories

PROJECT SUMMARY Over 70% of U.S. adults are classifiable as overweight or obese, and weight stigma, defined as the negative attitudes, prejudice, and discrimination directed at heavier individuals, is highly prevalent. Our long-term goal is to understand and ultimately mitigate the negative behavioral effects of weight stigma that pose risk for obesity and cardiovascular disease. In order to achieve this goal, we must first gain a fundamental understanding of the causal processes of weight stigma and how it functions in people’s lives to promote obesity. Therefore, the focus of this basic experimental study in humans (BESH) is to use an experimental manipulation as a probe in order to gain a fundamental causal understanding of the obesogenic nature of weight stigma. Much of the available evidence tying weight stigma to poor health outcomes is observational, precluding conclusions regarding causality. The few existing experimental studies that can infer causality only assess immediate outcomes in artificial lab settings. Moreover, the literature has thus far focused on documenting the negative effects of weight stigma, without attending to resilience factors that could confer protection against them. Therefore, our overall objectives are to (1) test the central hypothesis that weight stigma causes decrements in health behaviors in everyday life using ecological momentary assessment (EMA) and actigraphy, and (2) identify resilience factors that could, in future work, be targeted in weight stigma interventions. The central hypothesis is based on existing literature and our 8 preliminary studies, which include a study of 2,000 participants census-matched to U.S. population demographics demonstrating associations between greater weight stigma and binge eating and sleep disturbance. Our focus on health behaviors is important because behaviors account for 40% of preventable deaths and are strongly protective against obesity and cardiovascular disease. Moreover, there is evidence that the COVID-19 pandemic is detrimentally impacting diet, exercise, and sleep. Using a true experimental design, we will therefore pursue the following aims that capitalize on our deep experience manipulating weight stigma in laboratory experiments and our demonstrated expertise in ecological momentary assessment and actigraphy studies. AIM 1: Test the causal effects of weight stigma on diet, physical activity, and sleep in everyday life—we will randomly assign participants to a weight stigma vs. control manipulation and measure changes health behaviors in their everyday lives (3-day diet as captured by EMA food diaries, objectively measured physical activity captured by 24-hour actigraphy, and sleep, captured objectively by overnight actigraphy and subjectively self-reported sleep measures). AIM 2: Identify resilience factors that confer protection against the causal effects of weight stigma—we will test moderators drawn from two sources of theory (identity/belongingness and stress/coping). This research will provide a fundamental understanding of weight stigma to potentially identify a future intervention target to ameliorate unfavorable health consequences for the hundreds of millions of Americans at risk for weight stigma, obesity, and cardiovascular disease.

项目摘要 超过70%的美国成年人被归类为超重或肥胖，而体重耻辱，被定义为消极的 针对较重个体的态度、偏见和歧视非常普遍。我们的长期目标是 了解并最终减轻体重耻辱对肥胖风险的负面行为影响 和心血管疾病。为了实现这一目标，我们必须首先从根本上了解 体重耻辱的因果过程，以及它如何在人们的生活中发挥作用，以促进肥胖。因此，重点 这项人类基础实验研究（BESH）的目的是使用实验操作作为探针， 对体重污名的致胖本质有一个基本的因果理解。多的可用 将体重耻辱与不良健康结果联系起来的证据是观察性的，排除了以下结论： 因果关系现有的少数几项可以推断因果关系的实验研究只评估了 人工实验室设置。此外，迄今为止，文献集中于记录体重的负面影响 在这种情况下，人们往往忽视了能够保护人们免受歧视的复原力因素。因此，我们的总体 目标是（1）检验体重耻辱导致健康行为减少的中心假设， 日常生活中使用生态瞬时评估（EMA）和活动记录，（2）确定弹性因素 在今后工作中，这可以成为衡量耻辱干预措施的目标。核心假设是基于现有的 文献和我们的8项初步研究，其中包括一项对2,000名参与者的研究， 人口统计学显示更大的体重耻辱与暴饮暴食和睡眠之间的关联 扰动我们对健康行为的关注很重要，因为健康行为占可预防疾病的40%。 它能有效预防肥胖和心血管疾病。此外，有证据表明， 2019冠状病毒病大流行对饮食、锻炼和睡眠造成了严重影响。使用真正的实验设计， 因此，我们将追求以下目标，利用我们在控制体重耻辱方面的丰富经验， 实验室实验和我们在生态瞬时评估和活动记录方面的专业知识 问题研究目的1：测试日常生活中体重污名对饮食、身体活动和睡眠的因果影响， 将随机分配参与者到一个重量耻辱与控制操纵和测量变化的健康 日常生活中的行为（EMA食物日记记录的3天饮食， 通过24小时腕动记录仪记录的活动，以及通过夜间腕动记录仪客观记录的睡眠， 自我报告的睡眠测量）。目标2：确定能够保护人们免受因果效应影响的弹性因素 我们将测试从两个理论来源（身份/身份和 压力/应对）。这项研究将提供一个基本的了解体重耻辱，以潜在地确定一个 未来的干预目标是改善数亿人的不利健康后果， 美国人面临体重耻辱、肥胖和心血管疾病的风险。