A State-Wide Initiative to Spread Effective Behavioral Weight Loss Strategies

描述（由申请人提供）：肥胖是一个主要的公共卫生问题。行为减肥计划已被证明是成功的，在减少体重和预防肥胖症的医疗并发症的发生。有必要制定具有成本效益的方法来传播这些减肥干预措施。该项目评估了一种传播减肥干预措施的创新方法。它使用一个自我维持的全州范围内的计划，称为“塑造罗得岛”，作为招募大量参与者的手段，并将该计划与有效的行为体重控制策略相结合，以改善减肥结果。塑造罗得岛是一个为期12周的计划，以帮助罗德岛人减肥和增加活动，通过互联网提供的团队为基础的竞争，其中招募了超过13,000名参与者在2009年。为了避免明显增加人员成本或参与者负担，Shape-Up罗得岛计划将通过行为减肥干预来加强，包括（1）通过基于糖尿病预防计划和展望未来的每周多媒体行为课程提供有关饮食、锻炼和行为策略的教育，参与者可以在他们的计算机上查看;以及（2）通过提交每周自我监测记录和计算机生成的个性化反馈来加强问责制。对这种强化干预的试点研究表明，Shape-Up RI的参与者很好地坚持了这些添加的成分，并且强化计划显着改善了Shape-Up RI计划中的体重减轻。我们建议对600名“塑形”罗得岛参与者进行随机对照试验，这些参与者将被随机分配接受为期12周的“塑形”罗得岛标准计划或增强计划，增强计划不仅包括标准“塑形”罗得岛计划，还包括每周视频行为课程和每周自动反馈。主要的假设是，强化计划将在第12周改善体重减轻。次要目的是比较6个月和12个月随访时体重减轻5%的参与者百分比以及与体重控制相关的行为变化，并进行成本效益和成本效用分析，比较两种方案。这种创新的干预措施，它使用全州范围内的宣传活动，结合有效的减肥成功的行为策略，有可能成为治疗肥胖症的重要公共卫生模式。 公共卫生相关性：行为减肥计划可以成功地降低体重，但这些计划适用于有限数量的超重和肥胖个体。该项目评估了一种独特的减肥方法，该方法将自我维持的减肥活动（用于推广）与行为减肥策略和增加问责制（以提高减肥成功率）的策略培训相结合。这种创新的组合有可能成为传播体重控制干预措施的具有成本效益的模式。

DESCRIPTION (provided by applicant): Obesity is a major public health problem. Behavioral weight loss programs have been shown to be successful in reducing body weight and preventing the onset of medical complications of obesity. There is a need to develop cost-effective approaches to disseminating these weight loss interventions. This project evaluates an innovative approach to disseminating weight loss interventions. It uses a self-sustaining statewide program called "Shape Up Rhode Island", as a means of recruiting large numbers of participants to the program and combines this program with effective behavioral weight control strategies to improve the weight loss outcome. Shape-Up Rhode Island is a 12 week program to help Rhode Islanders lose weight and increase activity through an Internet delivered team-based competition, which recruited over 13,000 participants in 2009. To avoid markedly increasing personnel costs or participant burden, the Shape-Up Rhode Island program will be enhanced with a behavioral weight loss intervention including (1) education about diet, exercise and behavior strategies delivered via weekly multi-media behavioral lessons based on the Diabetes Prevention Program and Look AHEAD, that can be viewed by the participant on their computer; and (2) increased accountability through submission of weekly self-monitoring records and computer-generated individualized feedback. A pilot study of this enhanced intervention indicated that participants in Shape-Up RI adhered well to these added components and that the enhanced program significantly improved weight losses in the Shape-Up RI program. We propose to conduct a randomized controlled trial with 600 Shape-Up Rhode Island participants who will be randomly assigned to receive the 12-week standard Shape-Up Rhode Island program or an enhanced program, which includes not only the standard Shape-Up Rhode Island program, but also weekly video behavioral lessons and weekly automated feedback. The primary hypothesis is that the enhanced program will improve weight losses at week 12. Secondary aims are to compare the treatments on percent of participants achieving a 5% weight loss, on 6 and 12-month follow-up, and on behavior changes related to weight control, and to conduct cost-effective and cost-utility analyses comparing the two programs. This innovative intervention, which uses a statewide campaign for outreach combined with effective behavioral strategies for weight loss success, has the potential to be an important public health model for the treatment of obesity. PUBLIC HEALTH RELEVANCE: Behavioral weight loss programs can successfully reduce body weight, but these programs are available to limited numbers of overweight and obese individuals. This project evaluates a unique weight loss approach that combines a self-sustaining weight loss campaign (for outreach) with training in behavioral weight loss strategies and strategies to increase accountability (to improve weight loss success). This innovative combination has the potential to be a cost-effective model for disseminating weight control interventions.