Program to Reduce Incontinence by Diet and Exercise (PRIDE)

尿失禁是一个常见的问题，妇女造成困扰，降低生活质量 以及日常功能的严重限制。超重女性患泌尿系统疾病的风险显著增加 超过65%的失禁妇女超重。短期初步数据 研究表明，减轻体重可以显著减少失禁发作。因此，减肥可能 提出了一种有前途的新方法，尿失禁治疗，一个可能产生级联 除了减少尿失禁的频率外，还能更广泛地改善健康状况。所以我们 我建议随机选择330名超重和肥胖的尿失禁妇女（两组各165人）， 临床中心）进行为期6个月的强化行为体重控制计划或常规护理，以确定 减肥对尿失禁频率和生活质量的短期影响，以确定最有可能的女性 从体重减轻中获益，并开始探索尿失禁的尿动力学机制 减肥后的改善。 为了使减肥对尿失禁的持久影响最大化，有必要生产 持续weig.ht亏损。然而，体重维持仍然是肥胖领域的挑战。因此，我们认为， 我们建议评估一个创新的、以理论为指导的体重维持计划，该计划将侧重于 增加对行为改变努力的动机和承诺，并将其与更高的标准进行比较， 注重技能的体重维持计划。在完成6个月的减肥计划后， 减肥组将被随机分配到12个月的标准、基于技能的维持计划或 以动机为中心的维护干预。结果将包括体重减轻，尿失禁频率 和18个月时的生活质量。如果有效的女性尿失禁，这种方法和策略， 创新的以动机为中心的维持干预可以在其他肥胖人群中进行检查。 WIN --为Incident Network减轻重量--汇集了一群独特的优秀和 经验丰富的研究者，在尿失禁、肥胖治疗和多中心合作方面具有专业知识， 在三个机构进行临床试验。拟议的研究设计将使我们能够有效地评估这两个 尿失禁的新治疗和增强体重维持的有前景的方法， 并因此在对妇女健康至关重要的几个临床领域做出实质性贡献。

Urinary incontinence is a common problem among women that causes distress, diminished quality of life and dramatic limitations in daily functioning. Overweight women are at significantly increased risk of urinary incontinence and over 65% of women with incontinence are overweight. Data from short-term, preliminary studies suggest that weight reduction may significantly reduce incontinence episodes. Thus, weight loss may present a promising new approach to urinary incontinence treatment, one likely to produce a cascade of broader health improvements in addition to reductions in frequency of urinary incontinence. Therefore, we propose to randomize 330 overweight and obese women with urinary incontinence (165 at each of two clinical centers) to a 6-month intensive behavioral weight control program or to usual care to determine the short-term effect of weight loss on frequency of incontinence and quality of life, to identify women most likely to benefit from weight loss and to begin to explore the urodynamic mechanisms underlying incontinence improvement following weight loss. To maximize enduring effects of weight loss on urinary incontinence, it will be necessary to produce sustained weig.ht loss. However, weight maintenance remains a challenge in the obesity field. Therefore, we propose to evaluate an innovative, theory-guided weight maintenance program that will focus on increasing motivation and commitment to behavior change efforts and compare this with a more standard, skills-focused weight maintenance program. After completing the 6-month weight loss program, women in the weight loss arm will be randomized to either a 12-month standard, skill-based maintenance program or to a motivationally-focused maintenance intervention. Outcomes will include weight loss, incontinence frequency and quality of life at 18 months. If effective in women with incontinence, the methods and strategies of this innovative motivationally-focused maintenance intervention can be examined in other obese populations. WIN - Weight Reduction for Incontinence Network - brings together a unique group of outstanding and experienced investigators with expertise in urinary incontinence, obesity treatment and multicenter collabora- tive clinical trials at three institutions. The proposed study design will allow us to efficiently evaluate both a novel treatment for urinary incontinence and a promising approach to enhancement of weight maintenance, and therefore to make substantive contributions to several clinical arenas critical to women's health.