Self-weighing for Weight Management in Adolescents with Obesity

肥胖青少年体重管理的自我称重

• 批准号: 10462745
• 负责人: Carolyn T Bramante
• 金额: $ 20.03万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-09 至 2025-08-08
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10462745
• 关键词: Accountability; Address; Adherence; Adolescence; Adolescent; Adolescent and Young Adult; Adolescent obesity; Adult; Behavior Therapy; Behavioral; Body Image; Body Weight decreased; Cardiometabolic Disease; Cessation of life; Clinic; Clinical; Counseling; Data; Development; Eating Behavior; Eating Disorders; Education; Electronic Health Record; Epidemiologic Methods; Extramural Activities; Face; Feedback; Focus Groups; Foundational Skills; Funding; Goals; Habits; Health; Height; High Prevalence; Home; Income; Intervention; Interview; K-Series Research Career Programs; Life Expectancy; Low income; Measurement; Measures; Medical; Medicine; Mentorship; Methods; Monitor; Moods; Obesity; Obesity associated disease; Parents; Patients; Physical activity; Physicians; Pilot Projects; Practice Management; Provider; Psychological reinforcement; Public Health; Randomized; Research Personnel; Risk; Safety; Scientist; Self Efficacy; Self Perception; Self-control as a personality trait; Stress; Surveys; Technology; Testing; Training Programs; Treatment Efficacy; Weight; Weight maintenance regimen; adolescent health; adolescent patient; adult obesity; age group; arm; base; cardiometabolism; clinical care; design; diabetes risk; dietary; digital; efficacy testing; evidence base; improved; individualized feedback; intervention effect; multidisciplinary; novel; obese patients; obesity treatment; premature; prospective; psychologic; remote monitoring; skills; social cognitive theory; theories; therapy design; tool; transmission process; treatment as usual; weight loss intervention; weight maintenance

PROJECT SUMMARY Approximately 20% of adolescents in the US have obesity, which is significant because of its many health consequences, including cardiometabolic disease leading to premature death. Treatment of obesity is particularly important for adolescents because obesity in this age group also increases the risk for lower income and lower educational attainment in adulthood. The cornerstone of all forms of obesity treatment is behavioral modification strategies that support daily dietary and physical activity change. Self-monitoring is a powerful behavioral tool that is grounded in Social Cognitive Theory. This theory states that greater self- awareness through proximate self-measurement improves self-efficacy, self-control, and self-reinforcement. Self-monitoring of weight through daily self-weighing (SW) at home has been found to be effective and safe for weight loss and maintenance in adults, particularly when there is external accountability for the home weights. Daily SW at home with accountability to clinic represents a scalable intervention that can be feasibly implemented into the clinical care for adolescents with obesity. However, daily SW at home has not been prospectively assessed in adolescent patients with obesity who are seeking obesity treatment. The objective of this proposal is to evaluate the feasibility, acceptability, safety, and estimate the effect on weight of daily SW at home, integrated with the electronic health record (EHR) and clinical care of adolescents with obesity. I will: 1) Use mixed methods to determine adolescent and parent perspectives on daily weighing on smart scales connected to the EHR as a tool for adolescents with obesity who are seeking weight loss treatment; 2) Determine clinician and clinic staff perspectives on daily weighing on connected to the EHR; and 3) Conduct a randomized, clinic-based pilot study to compare the feasibility, acceptability, safety, and estimate the effect size of three conditions in a weight management clinic for adolescents with obesity: a) usual care, b) usual care + daily SW at home on a simple scale, and c) usual care + daily SW at home on a smart scale that is connected to clinic (with individualized feedback to the patient). I will prospectively and serially assess mood, body image, stress, weight management practices, and disordered eating behaviors. This project will generate critical preliminary data to inform the design of a larger study (R01) that fully evaluates safety and efficacy of daily SW at home, with and without regular external accountability from clinic, in adolescents with obesity. Completing this K23 training program will allow me to establish skills in mixed methods, epidemiologic methods and intervention design, and foundational skills in implementation of digital technology, as well as lay the groundwork for leading novel and high-impact obesity studies. The multidisciplinary mentorship during this career development award will prepare me to become an independent, extramurally-funded clinician scientist who investigates clinic-based interventions for obesity treatment.

项目摘要 在美国，大约20%的青少年患有肥胖症，这是很重要的，因为它的许多健康问题。 结果，包括导致过早死亡的心脏代谢疾病。肥胖症的治疗是 对青少年尤其重要，因为这个年龄组的肥胖也会增加低血糖的风险。 成年后收入和教育程度较低。所有形式的肥胖治疗的基础是 支持日常饮食和身体活动改变的行为矫正策略。自我监督是一种 一个基于社会认知理论的强大的行为工具。这一理论认为，更大的自我- 通过近似自我测量的意识提高了自我效能、自我控制和自我强化。 通过每天在家自我称重（SW）自我监测体重已被发现是有效和安全的， 成年人的体重减轻和维持，特别是当家庭体重有外部责任时。 每天在家进行SW，并对诊所负责，这是一种可行的可扩展干预措施 应用于肥胖青少年的临床治疗。然而，每天在家的SW并没有被 在寻求肥胖治疗的青少年肥胖患者中进行前瞻性评估。的目标 本提案旨在评价可行性、可接受性、安全性，并估计每日SW对体重的影响， 家庭，与电子健康记录（EHR）和肥胖青少年的临床护理相结合。我会：1） 使用混合方法来确定青少年和家长对智能秤上每日称重的看法 连接到EHR，作为寻求减肥治疗的肥胖青少年的工具; 2） 确定临床医生和诊所工作人员对连接到EHR的日常称重的看法;以及3） 进行一项随机、基于临床的初步研究，以比较可行性、可接受性、安全性和估计 肥胖青少年体重管理诊所中三种条件的效应量：a）常规护理，B） 常规护理+简单量表上的每日家庭SW，以及c）常规护理+智能量表上的每日家庭SW， 连接到诊所（向患者提供个性化反馈）。我将前瞻性地连续评估情绪， 身体形象、压力、体重管理实践和饮食失调行为。该项目将产生 关键的初步数据，以通知设计一项更大的研究（R 01），充分评价安全性和有效性 在肥胖青少年中，每天在家进行SW，有或没有来自诊所的定期外部问责。 完成这个K23培训计划将使我能够建立混合方法，流行病学方法， 和干预设计，以及实施数字技术的基本技能，以及奠定 为领导新的和高影响力的肥胖研究奠定基础。在此期间的多学科指导 职业发展奖将使我成为一个独立的，校外资助的临床科学家 他调查了肥胖治疗的临床干预措施。