Novel Approaches to Weight Loss Maintenance

维持减肥的新方法

• 批准号: 7294898
• 负责人: NANCY E. SHERWOOD
• 金额: $ 53.16万
• 依托单位: HEALTHPARTNERS INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-28 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7294898
• 关键词: Address; Adherence; Adult; Aftercare; Behavior; Behavioral; Body Weight; Body Weight Changes; Body Weight decreased; Classification; Cognitive; Condition; Data; Development; Diet; Dietary intake; Dose; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Fatty acid glycerol esters; Feedback; Gender; Habits; Health; Individual; Intervention; Just-in-time-concept; Kilogram; Length; Maintenance; Mediating; Methods; Modeling; Monitor; Obesity; Outcome; Participant; Phase; Physical activity; Pilot Projects; Prevalence; Principal Investigator; Printing; Problem Solving; Process; Process Measure; Public Health; Randomized; Randomized Controlled Clinical Trials; Recommendation; Recruitment Activity; Registries; Relative (related person); Reporting; Research; Schedule; Self Efficacy; Social support; Standards of Weights and Measures; Subgroup; Telephone; Time; United States; Weight; Weight Gain; Weight maintenance regimen; Wing; Woman; base; comparison group; cost; design; early /brief intervention /therapy; experience; follow-up; improved; innovation; men; novel; novel strategies; obesity treatment; outreach; programs; response; skills; treatment duration; trend; trial comparing; weight loss intervention; weight maintenance

DESCRIPTION (provided by applicant): Weight loss maintenance is a critical challenge for obesity treatment. Extended treatment length and enactment of key behaviors (e.g., physical activity, self-monitoring) can improve maintenance. Treatment studies have incorporated these strategies; however, the most intensive treatment typically occurs during weight loss initiation with the maintenance phase occurring after treatment novelty has faded. Increasing duration improves weight loss, but there is a point of diminishing returns as people eventually stop attending sessions. Recruiting people who have recently lost weight to a maintenance-specific intervention may be a viable alternative. A key issue for maintenance-specific interventions is defining the optimal timing of delivery. One approach suggests that maintenance will be enhanced by teaching people about the key behaviors required and assisting them with these behaviors. Following this approach, maintenance programs would be designed like weight loss programs where sessions addressing relevant behaviors occur on a pre- set schedule. Another approach recognizes that maintenance inevitably includes periods of weight regain and will be enhanced if individuals use cognitive and behavioral strategies to reverse small weight gains. Following this approach, intervention contact would occur in a "just-in-time" manner, in response to weight trends. Data from our Keep It Off pilot study suggest that effectiveness may be maximized by integrating these two complementary approaches and including core content, continued support and tailored feedback. We propose to evaluate the efficacy of this innovative approach to promoting long-term maintenance among adults who have recently lost weight. Four hundred adults who have recently lost at least 5 percent of their weight will be recruited and randomly assigned to: 1) a brief intervention comparison group during which participants will receive two phone sessions addressing key maintenance behaviors or 2) an enhanced scheduled maintenance intervention (SMI+) that includes a core set of phone sessions addressing maintenance behaviors and a second phase with bimonthly continued support calls, monthly tailored feedback reports and "just in time" support to reverse small weight gains. Outcomes will be assessed at 6, 12, 18, and 24 months, with 24-month weight change and maintenance as the primary outcomes. The proposed research is innovative because it targets individuals who have recently lost weight and evaluates a novel intervention to enhance weight maintenance. Results will provide important information on the effectiveness of a new weight loss maintenance intervention that could potentially be widely disseminated.

描述（由申请人提供）：维持体重减轻是肥胖治疗的关键挑战。延长治疗时间和制定关键行为（例如身体活动、自我监控）可以改善维持。治疗研究已纳入这些策略；然而，最强化的治疗通常发生在减肥开始期间，维持阶段发生在治疗的新鲜感消失之后。增加持续时间可以改善减肥效果，但随着人们最终停止参加课程，效果会出现递减点。招募最近减肥的人进行针对维护的干预可能是一个可行的选择。特定维护干预措施的一个关键问题是确定最佳交付时间。一种方法表明，通过教导人们所需的关键行为并帮助他们进行这些行为，可以增强维护。按照这种方法，维护计划将像减肥计划一样设计，其中针对相关行为的会议按照预设的时间表进行。另一种方法认识到，维持体重不可避免地包括体重反弹的时期，如果个人使用认知和行为策略来扭转体重的小幅增加，维持体重就会得到加强。按照这种方法，干预接触将以“及时”的方式发生，以响应体重趋势。我们的 Keep It Off 试点研究的数据表明，通过整合这两种互补的方法并包括核心内容、持续支持和量身定制的反馈，可以最大限度地提高有效性。我们建议评估这种创新方法对促进最近减肥的成年人长期维持体重的功效。将招募最近体重减轻至少 5% 的 400 名成年人，并随机分配到：1) 一个简短的干预对照组，在此期间参与者将接受两次针对关键维护行为的电话会议，或 2) 增强定期维护干预 (SMI+)，其中包括一组针对维护行为的核心电话会议，以及包含每两个月持续支持电话、每月定制反馈报告和“及时”支持的第二阶段 扭转体重的小幅增长。结果将在 6、12、18 和 24 个月时进行评估，其中 24 个月的体重变化和维持情况作为主要结果。拟议的研究具有创新性，因为它针对的是最近减肥的个体，并评估了一种增强体重维持的新干预措施。结果将提供有关新的减肥维持干预措施有效性的重要信息，该干预措施有可能被广泛传播。