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

描述（由申请人提供）：肥胖是一个重大的公共健康问题。行为减肥计划已被证明在减轻体重和预防肥胖并发症的发生方面是成功的。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。本项目评估一种传播减肥干预措施的创新方法。它采用了一个名为“罗德岛塑形”的自我维持的全州项目，作为招募大量参与者的手段，并将该项目与有效的行为体重控制策略相结合，以改善减肥效果。“罗德岛塑形”是一个为期12周的项目，旨在帮助罗德岛居民减肥，并通过互联网上的团队比赛增加运动量，该项目在2009年招募了13000多名参与者。为了避免显著增加人员成本或参与者负担，罗德岛塑形计划将加强行为减肥干预，包括(1)通过每周一次的基于糖尿病预防计划和Look AHEAD的多媒体行为课程提供有关饮食、运动和行为策略的教育，参与者可以在他们的电脑上观看；(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增加问责制。一项针对这种强化干预的试点研究表明，Shape-Up RI的参与者很好地遵守了这些增加的成分，并且强化计划显著改善了Shape-Up RI计划的体重减轻。我们建议对600名Shape-Up罗德岛参与者进行随机对照试验，他们将被随机分配接受为期12周的标准罗德岛Shape-Up计划或强化计划，其中不仅包括标准罗德岛Shape-Up计划，还包括每周的视频行为课程和每周的自动反馈。主要的假设是，强化计划将在第12周改善体重减轻。第二个目的是比较6个月和12个月的随访中，达到5%体重减轻的参与者的百分比，以及与体重控制相关的行为改变，并对两个方案进行成本效益和成本效用分析。这种创新的干预措施，利用全州范围内的宣传活动，结合有效的减肥行为策略，有可能成为治疗肥胖的重要公共卫生模式。

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.