Development of an integrative intervention to decrease overeating drive and improve weight loss maintenancee

开发综合干预措施以减少暴饮暴食并改善减肥维持

• 批准号: 10468150
• 负责人: Rachel Miller Radin
• 金额: $ 17.21万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10468150
• 关键词: Address; Adult; Area; Awareness; Behavioral; Binge Eating; Body Weight decreased; Clinical; Collaborations; Communities; Consultations; Data; Development; Drops; Eating; Eating Behavior; Educational Status; Enrollment; Evaluation; Failure; Fellowship; Focus Groups; Goals; Health; Healthy Eating; Hunger; Hyperphagia; Individual; Insulin Resistance; Integrative Medicine; Intervention; K-Series Research Career Programs; Knowledge; Lead; Light; Maintenance; Measures; Meditation; Mentored Patient-Oriented Research Career Development Award; Mentors; Metabolic; Metabolic dysfunction; Metabolic syndrome; Mindfulness Training; Motivation; National Center for Complementary and Integrative Health; Obesity; Overweight; Participant; Pattern; Phase; Pilot Projects; Psychologist; Public Health; Qualitative Research; Randomized; Randomized Controlled Trials; Reading; Research; Research Personnel; Sampling; Science; Self Efficacy; Testing; Touch sensation; Training; United States; Weight; Weight Gain; Work; active control; adult obesity; base; behavior change; career; career development; craving; design; diaries; digital; effective therapy; emotional eating; evidence base; high risk; high risk population; improved; infancy; meetings; mindfulness; mindfulness intervention; motivational enhancement therapy; motivational intervention; novel; patient oriented research; pilot test; programs; psychologic; symptom management; symptom science; therapy design; therapy development; trait; treatment effect; weight loss intervention; weight loss program

Project Summary/Abstract A critical problem facing behavioral weight-loss interventions for adults with obesity is the tendency towards weight regain following weight loss. This is due in part to a failure to address the behavioral lynchpins that underlie obesity for a significant subset: overeating drive (e.g., eating for psychological relief, compulsive eating). This drive can independently lead to insulin resistance and metabolic syndrome, making it a crucial behavioral target. The objective of this K23 Mentored Patient-Oriented Research Career Development application is to provide me with high-level training to become an expert in targeting overeating drive, using mindfulness-based and motivational approaches to promote healthy eating. Mindful eating (ME) components may be an important addition to weight loss programs to more directly target overeating drive. Motivational interviewing (MI) is already established as an effective treatment component to help with weight loss and may help reduce overeating drive. No studies have examined MI in combination with ME, herein referred to as ‘Mindful Motivation’ (MM). Congruent with NCCIH’s initiative on advancing the science of symptom management through integrative health interventions, the proposed project aims to 1) identify and optimize specific targets of MM interventions that may reduce overeating drive and 2) pilot test the refined MM intervention in an RCT design with an active control condition (general digital mindfulness). To this end, I will examine pilot study data in which adults with overweight receive 8-weeks of MM. Based on these findings, along with data from focus groups and consultation with a team of experts, I will identify which aspects of the MM intervention most strengthened the target (overeating drive) and optimize these components. I will develop a light touch intervention utilizing both MI and ME components. I will examine which treatment components are most effective (in comparison to the active control) in targeting mechanisms of overeating drive (primarily self- efficacy, impulse control). Preliminary findings will inform an R-level application that evaluates the MM intervention in an adequately powered RCT. This research will help develop mindfulness-based treatments most suitable for adults with overweight and overeating drive, and may promote long-term metabolic health. Building on my advanced training as a clinical health psychologist with expertise in eating behavior, the K23 mechanism addresses my critical training needs in mechanism-focused intervention development and evaluation. The training plan includes coursework, meetings, readings, and qualitative research to fill these gaps. I have assembled an outstanding team of mentors and advisors at UCSF (Drs. Epel, Mason, Adler, Hartogensis, Le Grange, and Garber) and outside of UCSF (Drs. Wolever, Cassin and West) with expertise in complementary areas. As my long-term career goal is to develop and disseminate integrative interventions to improve the health of individuals with obesity, the K23 mechanism will provide me with opportunities to grow as an independent clinical researcher, and develop better evidence-based strategies.

项目概要/摘要 肥胖成人行为减肥干预面临的一个关键问题是减肥后体重反弹的趋势。部分原因是未能解决导致肥胖的一个重要子集的行为关键：暴饮暴食（例如，为了心理缓解而进食、强迫性进食）。这种驱动力可以独立导致胰岛素抵抗和代谢综合征，使其成为重要的行为目标。这个 K23 指导的以患者为导向的研究职业发展应用程序的目标是为我提供高水平的培训，使我成为针对暴饮暴食的专家，使用基于正念和激励的方法来促进健康饮食。正念饮食（ME）成分可能是减肥计划的重要补充，可以更直接地针对暴饮暴食。动机访谈 (MI) 已被确立为一种有效的治疗方法，有助于减肥，并可能有助于减少暴饮暴食。尚无研究将 MI 与 ME（本文称为“正念动机”（MM））结合起来进行检验。与 NCCIH 通过综合健康干预措施推进症状管理科学的倡议相一致，拟议项目旨在 1) 确定和优化可减少暴饮暴食的 MM 干预措施的具体目标，2) 在主动控制条件（一般数字正念）的 RCT 设计中对完善的 MM 干预进行试点测试。为此，我将检查试点研究数据，其中超重成年人接受 8 周的 MM。根据这些发现，再加上焦点小组的数据以及专家团队的咨询，我将确定 MM 干预的哪些方面最能强化目标（暴饮暴食驱动力）并优化这些组成部分。我将利用 MI 和 ME 组件开发轻触干预。我将研究哪些治疗成分在针对暴饮暴食驱动机制（主要是自我效能、冲动控制）方面最有效（与主动控制相比）。初步结果将为 R 级应用程序提供信息，该应用程序在充分动力的 RCT 中评估 MM 干预。这项研究将有助于开发最适合超重和暴饮暴食成年人的基于正念的治疗方法，并可能促进长期代谢健康。 基于我作为一名具有饮食行为专业知识的临床健康心理学家的高级培训，K23 机制满足了我在以机制为中心的干预开发和评估方面的关键培训需求。培训计划包括课程作业、会议、阅读和定性研究，以填补这些空白。我在加州大学旧金山分校（Epel、Mason、Adler、Hartogensis、Le Grange 和 Garber 博士）和加州大学旧金山分校外部（Wolever、Cassin 和 West 博士）组建了一支优秀的导师和顾问团队，他们在互补领域拥有专业知识。由于我的长期职业目标是开发和传播综合干预措施以改善肥胖症患者的健康，K23 机制将为我提供成长为独立临床研究员的机会，并制定更好的循证策略。