Motivating Obese Adolescents to Reduce Risk for Diabetes

描述（申请人提供）：改变饮食和身体活动行为是预防肥胖青少年2型糖尿病治疗的基石。然而，青少年往往对改变行为感到矛盾。这种矛盾心理可能是传统治疗方案长期效果不佳的基础。虽然青少年想要自主权，可能会抵制建议，但他们需要父母的支持才能取得成功。许多关于肥胖青少年治疗策略的行为和代谢影响的问题仍然没有答案，代表了未来研究的前景。从长远来看，Ebbeling博士致力于研究动机和行为过程如何与饮食和体育活动的代谢效应相互作用，以影响减肥的维持和降低2型糖尿病的风险。研究职业奖将为她提供机会：1）扩大她对2型糖尿病，行为改变理论和青少年健康的知识; 2）将新知识与她在营养，体育活动和肥胖方面的专业知识结合起来，设计创新的激励干预措施; 3）在进行临床试验中发挥领导作用。拟议的研究项目将是职业发展的关键工具，对减少与肥胖和2型糖尿病相关的发病率具有重要意义。该项目的目的是评估一种指导性的、以病人为中心的咨询方式，以1）帮助肥胖女孩（13至16岁）改变饮食和体育活动行为，2）使她们的母亲能够提供所需的支持。女儿-母亲对（N=40）将随机接受动机行为改变咨询（MBCC）或标准护理咨询（SCC）6个月，治疗控制接触时间。根据研究假设，与SCC相比，MBCC的主要（饮食质量，体力活动）和次要（体重指数，胰岛素抵抗）结果的变化将更有利。影响行为的家庭因素是将探讨的几个中介变量之一。在促进初级教师发展的环境中，与路德维希博士，彼得森博士，索伦森博士和Wypij博士的互动将确保该项目的成功完成，并促进Ebbeling博士的独立性。

DESCRIPTION (provided by applicant):Modification of diet and physical activity behaviors is the cornerstone of treatment for preventing type 2 diabetes in obese adolescents. However, teenagers often are ambivalent about changing behaviors. This ambivalence may underlie poor long-term outcomes with conventional treatment programs. While adolescents want autonomy and may resist advice, they need parental support to achieve success with treatment. Many questions concerning behavioral and metabolic effects of strategies for treating obese adolescents remain unanswered and represent promising areas for future research. From a long-term perspective, Dr. Ebbeling is committed to a career focusing on how motivational and behavioral processes interact with metabolic effects of diet and physical activity to influence maintenance of weight loss and reduced risk for type 2 diabetes. A research career award will provide the opportunity for her to 1) expand her knowledge of type 2 diabetes, behavior change theory, and adolescent health; 2) integrate new knowledge with her expertise in nutrition, physical activity, and obesity in designing innovative motivational interventions; and 3) take a leadership role in conducting a clinical trial. The proposed research project will be a critical vehicle for career development and has important implications for reducing morbidities associated with obesity and type 2 diabetes. The aim of the project is to evaluate a directive, patient-centered counseling style for 1) assisting obese girls (13 to 16 years) in modifying diet and physical activity behaviors and 2) equipping their mothers to provide needed support. Daughter-mother dyads (N=40) will be randomized to Motivational Behavior Change Counseling (MBCC) or Standard of Care Counseling (SCC) for 6 months, with treatments controlled for contact time. According to study hypotheses, changes in primary (diet quality, physical activity) and secondary (body mass index, insulin resistance) outcomes will be more favorable with MBCC compared to SCC. Familial factors that influence behaviors are among several mediating variables that will be explored. In an environment that fosters development of junior faculty, interactions with Drs. Ludwig, Peterson, Sorensen, and Wypij will ensure successful completion of this project and promote Dr. Ebbeling's progress towards independence.