Modifying obesogenic homes: Impact on weight maintenance

改造致肥胖的房屋：对维持体重的影响

• 批准号: 7221240
• 负责人: Amy A Gorin
• 金额: $ 14.24万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-05-01 至 2007-08-22
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7221240
• 关键词: Address; Adherence; Affect; Arts; Behavior; Behavior Therapy; Behavioral; Behavioral Model; Body Weight Changes; Body Weight decreased; Calories; Characteristics; Chronic Disease; Condition; Control Groups; Dietary intake; Disease model; Eating; Educational process of instructing; Environment; Epidemic; Equipment; Exercise; Family member; Fatty acid glycerol esters; Food; Goals; Habits; Health Promotion; Health behavior; Home environment; Hour; Hyperphagia; Individual; Instruction; Internet; Intervention; Investigation; Knowledge; Left; Life Style; Literature; Maintenance; Mediating; Mental Depression; Modeling; Modification; Motivation; Numbers; Obesity; Overweight; Participant; Pattern; Physical activity; Randomized; Rate; Research Personnel; Spouses; Standards of Weights and Measures; Stimulus; Television; Testing; Time; United States; Vacuum; Very Light Exercise; Week; Weight; Weight maintenance regimen; Woman; Work; base; behavior change; design; diaries; improved; innovation; men; monitoring device; pressure; programs; sedentary; skills; social; staff intervention; success; theories; treatment duration; treatment program; weight maintenance

DESCRIPTION (provided by applicant): The obesity epidemic observed in recent years can be largely attributed to an obesogenic environment that encourages overeating and sedentary lifestyles. Behavioral weight control treatment, the most empirically validated intervention approach, produces initial weight losses of 10%; however, maintenance of initial weight loss and behavior change has not been achieved. These disappointing long-term results may reflect the fact that participants are given only minimal, indirect instruction on how to change their environment to support their new weight-regulating behaviors. While in theory, the behavioral model emphasizes environmental antecedents and consequences of eating and exercise, in practice, only 1 to 2 sessions in standard treatment are dedicated to stimulus control-types of skills. By teaching weight control skills in a contextual vacuum, participants remain vulnerable to the same environmental influences that maintained their unhealthy eating and exercise habits. Given that the majority of eating and exercise is home-based, a logical step in strengthening behavioral treatment and moving toward an ecological model of behavior is to expand the focus of treatment from the individual to the individual plus their home environment. We propose to test the long-term impact of a behavioral weight control program designed to directly modify both the physical and social home environment of weight loss participants. Two hundred overweight and obese men and women will be randomly assigned to either 24 months of standard behavioral treatment (SBT) or 24 months of standard behavioral treatment plus direct modifications to the home environment (SBT+Home). SBT+Home will incorporate many strategies that have shown promise in improving weight loss (e.g., food and exercise equipment provision, spouse involvement) but will be the first to study both physical and social factors within the home simultaneously and will be the longest examination of the home environment conducted to date. Participants and spouses will be assessed at baseline, 6, 12, 18, and 24 months. We hypothesize that by broadening the focus of treatment from the individual to the individual plus their home environment, SBT+Home will produce both better long-term weight loss and better maintenance of initial weight loss and behavior change. This home environmental approach, if successful, has potential applications to the maintenance of other important health behaviors.

描述（由申请人提供）：近年来观察到的肥胖流行很大程度上归因于肥胖的环境，这种环境鼓励了暴饮暴食和久坐的生活方式。行为体重控制治疗方法是最经验验证的干预方法，最初的体重减轻为10％；但是，尚未实现最初的体重减轻和行为改变。这些令人失望的长期结果可能反映了一个事实，即仅赋予参与者关于如何改变其环境以支持其新的体重调节行为的最小，间接指导。从理论上讲，行为模型强调了饮食和锻炼的环境先例和后果，但实际上，标准治疗中只有1到2次疗法专门用于刺激控制技能。通过在上下文真空中教授体重控制技能，参与者仍然容易受到保持不健康饮食和运动习惯的相同环境影响。鉴于大多数饮食和运动都是基于家庭的，因此加强行为治疗并朝着行为的生态模型迈进的逻辑步骤是将治疗的重点从个人扩展到个人，再加​​上其家庭环境。我们建议测试旨在直接修改减肥参与者的身体和社会家庭环境的行为体重控制计划的长期影响。两百个超重和肥胖的男人和女性将被随机分配给24个月的标准行为治疗（SBT）或24个月的标准行为治疗，以及对家庭环境（SBT+Home）的直接修改。 SBT+房屋将纳入许多策略，这些策略在改善体重减轻（例如食品和运动设备提供，配偶参与）方面有希望，但将是第一个同时研究家庭和社会因素的人，并且将是迄今为止对家庭环境进行最长的检查。参与者和配偶将在基线，6、12、18和24个月进行评估。我们假设，通过将治疗的重点从个人扩大到个人加上他们的家庭环境，SBT+家庭将既可以产生更好的长期体重减轻，又可以更好地维持初始体重减轻和行为改变。如果成功的话，这种家庭环境方法在维持其他重要的健康行为方面有潜在的应用。