Weight Management Skills--African American Outpatients

描述（由申请人提供）：非裔美国人心血管疾病（CVD）的风险很高，但在减肥和改变生活方式方面通常取得的成功有限。我们建议研究社会支持，特别是来自家庭成员和朋友的支持，在促进非裔美国人减肥和相关饮食和体育活动改变方面的作用。男性和女性将从城市、大学卫生系统和周围社区招募。有资格作为“指数”参与者的是非裔美国人，年龄在35至70岁之间（n=128），体重指数（BMI）为27至50 kg/m2，至少有一种与肥胖相关的合并症或临床心血管疾病风险因素。我们鼓励（但不要求）指数参与者列出1至2名家庭成员或朋友作为共同参与者。如果他们的年龄在16到70岁之间，并且按照成人或青少年的BMI标准，他们的BMI与指数参与者的范围相同，那么他们将符合条件。所有指标参与者将接受相同的小组、行为咨询计划，并辅以个人咨询。联系将是每周，然后每两周，然后每月超过24个月。指名共同参与者的指数参与者将按1:1的比例随机分配到高（a组，家庭成员和朋友直接参与）或低（B组，家庭成员和朋友间接参与）的社会支持条件。在A组，索引和共同参与者都将包括在所有的咨询会议中。在B组中，共同参与者将不包括在小组咨询会议中，但将获得自助材料，并邀请陪同指数参与者参加个人咨询会议。没有确定共同参与者的指数参与者（n=64）将按1:1的比例随机分配到高（C组，分配到与其他指数参与者一起的团队）或低（D组，没有这样分配）的社会支持。体重、临床心血管疾病风险、饮食、身体活动、心理社会因素和社会支持的数据将在基线和每半年从参与者那里收集，对于大多数变量，将从共同参与者那里收集。主要假设是，A组与B组、C组与0组相比，0 - 12个月、0 - 24个月的体重减轻和12 - 24个月的体重维持效果更好。二级分析将比较各自治疗组和对照组在饮食、身体活动和临床心血管疾病危险因素变化方面的差异，并将评估结果和成本效益的预测因素。

DESCRIPTION (provided by applicant): African Americans are at high risk of cardiovascular disease (CVD) but generally have limited success in weight loss and lifestyle change programs. We propose to examine the role of social support, particularly from family members and friends, in facilitating weight loss and related dietary and physical activity changes in African Americans. Men and women will be recruited from an urban, university health system and the surrounding community. Those eligible as "index" participants will be African Americans ages 35 to 70 years (n=128) with a body mass index (BMI) of 27 to 50 kg/m2 and at least one obesity-related co-morbidity or clinical CVD risk factor. Index participants will be encouraged but not required to name 1 or 2 family member or friend co-participants. Co-participants will be eligible if they are aged 16 to 70 years and have a BMI in the same range as index participants by adult or adolescent BMI criteria. All index participants will receive the same group, behavioral counseling program supplemented with individual counseling. Contact will be weekly, then biweekly, then monthly over 24 months. Index participants who name co-participants will be randomly assigned in a 1:1 ratio to high (Group A, direct involvement of family members and friends) or low (Group B, indirect involvement of family members and friends) social support conditions. In Group A, both index and co-participants will be included in all counseling sessions. In Group B, co-participants will not be included in group counseling sessions but will be given self-help materials and invited to accompany index participants to individual counseling sessions. Index participants who do not identify co-participants (n=64) will be randomly assigned in a 1:1 ratio to high (Group C, assigned to teams with other index participants) or low (Group D, not so assigned) social support. Data on weight, clinical CVD risk, diet, physical activity, psychosocial factors and social support will be collected from participants and, for most variables, from co-participants at baseline and semiannually. Primary hypotheses are that weight loss from 0 to 12 months, 0 to 24 months, and weight maintenance from 12 to 24 months will be greater in Group A vs. Group B and in Group C vs. Group 0. Secondary analyses will compare the respective treatment and control groups on diet, physical activity, and clinical CVD risk factor changes and will assess predictors of outcomes and cost-effectiveness.