Weight Management Skills--African American Outpatients

描述（由申请人提供）：非裔美国人是心血管疾病（CVD）的高风险，但通常在减肥和生活方式改变计划的成功有限。我们建议研究社会支持的作用，特别是来自家庭成员和朋友，在促进减肥和相关的饮食和体育活动的变化在非洲裔美国人。将从城市、大学卫生系统和周围社区招募男性和女性。有资格作为“指数”参与者的是年龄在35至70岁之间的非裔美国人（n=128），体重指数（BMI）为27至50 kg/m2，至少有一种肥胖相关的合并症或临床CVD风险因素。我们鼓励指数参与者，但不要求他们说出1或2名家庭成员或朋友的共同参与者。如果共同参与者的年龄在16至70岁之间，并且根据成人或青少年BMI标准，其BMI范围与指数参与者相同，则他们将有资格参加研究。所有指数参与者将接受相同的团体，行为辅导计划，辅以个人辅导。联系将每周，然后每两周，然后每月超过24个月。指定共同参与者的索引参与者将以1：1的比例随机分配到高（A组，家庭成员和朋友的直接参与）或低（B组，家庭成员和朋友的间接参与）社会支持条件。在A组中，索引和共同参与者将被包括在所有的咨询会议。在B组，共同参与者将不包括在小组咨询会议，但将给予自助材料，并邀请陪同索引参与者个人咨询会议。未确定共同参与者的指数参与者（n=64）将以1：1的比例随机分配到高（C组，分配到有其他指数参与者的团队）或低（D组，未如此分配）社会支持。将在基线和每半年从受试者和共同受试者（对于大多数变量）中收集体重、临床CVD风险、饮食、体力活动、心理社会因素和社会支持的数据。主要假设是，A组与B组相比，C组与0组相比，0 - 12个月、0 - 24个月的体重减轻和12 - 24个月的体重维持更大。次要分析将比较各自治疗组和对照组的饮食、体力活动和临床CVD风险因素变化，并评估结局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.