WEIGHT CONNECTION: WEIGHT LOSS MAINTANANCE USING THE WEB

体重连接：使用网络进行减肥维持

• 批准号: 6381778
• 负责人: LEE MICHAEL KAPLAN
• 金额: $ 21.34万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6381778
• 关键词: Internet; behavioral /social science research tag; clinical research; computer assisted patient care; computer system design /evaluation; group therapy; health behavior; health services research tag; human subject; human therapy evaluation; motivation; patient care personnel relations; self help; telemedicine; weight control; weight loss

Despite widespread recognition of the increasing prevalence and medical sequelae of obesity, efforts to reverse these trends have met with limited success. Although 75 percent of obese individuals who enter a weight loss program are initially successful, more than 90 percent of these individuals regain the lost weight within 5 years, leading to renewal or even exacerbation of cardiopulmonary and vascular disease risks. The focus of this proposal is the prevention of weight regain in obese individuals after successful weight loss. The best predictor of weight loss maintenance is the duration and intensity of patient-provider contact, irrespective of practitioner specialty or the nature of the intervention. However, the high costs of intensive interventions over an extended period limit optimal management to a small number of patients. The hypothesis underlying the proposed study is that some of the benefits of intensive patient-provider interaction can be achieved in a cost-efficient manner through creative use of electronic communication. We propose to develop a three-part, web-based program ("WeightConnection") that includes mechanisms for (1) ongoing, patient self-monitoring and graphical feedback about weight, eating and exercise behavior, (2) individual, electronic consultative advice from a weight counselor and (3) on-line group-based therapy and peer-to-peer communication. Our goals for this intervention are to achieve several benefits of intensive patient-provider interaction that appear to underlie successful weight loss maintenance, including sustained patient motivation, diminished attrition rates, and timely relapse management. Each component of the proposed program is designed to promote these goals by providing personal guidance, educational opportunities and psychological support. We will initially test and refine the WeightConnection program with a small group of patient volunteers recruited from MGH Weight Center patients. Thereafter, we will examine whether this intervention improves the success of a standard group-based program in maintaining weight loss. We will conduct a randomized, controlled study in 30-40 patients, comparing the combination of the WeightConnection program and standard therapy vs. standard therapy alone. The results of this pilot study, including effects on weight maintenance and patient retention, preliminary subgroup analysis and careful assessment of patient usage and feedback, will be used to design a more definitive study of the efficacy and cost-effectiveness of electronic communication for prevention of recurrent weight gain.

尽管对肥胖症的患病率和医学后遗症的日益严重，但扭转这些趋势的努力却取得了有限的成功。 尽管最初有75％的肥胖个体进入减肥计划是成功的，但这些人中有超过90％会在5年内恢复体重减轻，从而导致心肺和血管疾病风险的更新甚至加剧。 该提案的重点是成功减肥后预防肥胖个体的体重恢复。 减肥维持的最佳预测指标是患者提供者接触的持续时间和强度，无论从业者专业或干预性质如何。但是，在延长期间，强化干预措施的高昂成本限制了少数患者的最佳管理。 拟议的研究的基本假设是，通过创造性地利用电子通信，可以以具有成本效益的方式来实现密集型患者互动的某些好处。 我们建议开发一个基于Web的三部分的程序（“重量连接”），其中包括（1）持续的，患者的自我监控和有关体重，饮食和运动行为的图形反馈，（2）个人，体重顾问的个人咨询建议以及（3）在线组基于线治疗和对等点对点，以及PEER-PEER-TOE-PEER-PEER-PEER-PEER-PEER-PEER交流。 我们的这项干预目标是获得密集的患者互动的几个好处，这些互动似乎是成功的减肥维持的基础，包括持续的患者动机，损耗率降低和及时的复发管理。 拟议计划的每个组成部分旨在通过提供个人指导，教育机会和心理支持来促进这些目标。 我们最初将与从MGH体重中心患者招募的一小部分患者志愿者一起测试和完善重量连接计划。 此后，我们将检查这种干预措施是否改善了基于标准组的计划在维持体重减轻方面的成功。 我们将在30-40名患者中进行一项随机，对照的研究，并将重量连接计划与标准疗法与仅标准治疗的组合进行比较。 这项试验研究的结果，包括对体重维持和患者保留的影响，初步亚组分析以及对患者使用和反馈的仔细评估，将用于设计对电子通信预防复发体重增加的电子通信的效果和成本效益的更确定性研究。