Improving Weight Loss Maintenance through Alternative Schedules of Treatment

描述(由申请人提供)： K23奖的候选人是一名初级教员，他的长期目标是从事学术研究，专注于改善肥胖治疗后的减肥维持，并将研究成果传播到临床应用环境中。为了实现这一目标，该奖项的具体培训目标包括：1)培养在应用临床环境(即管理型护理)中实施的延长护理减肥维持干预措施的交付和评估方面的专业知识；2)培养评估维持干预措施的研究方法和统计方法方面的专业知识；3)加深对肥胖和减肥的生物/生理方面的了解；4)发展维护计划成本效益评估方面的专业知识；5)开发R01应用程序，以进一步检验在应用环境中减肥维持的创新和有效方法。为了实现这些目标，候选人提出了一个为期五年的培训计划，在迈克尔·佩里博士的主要指导下，他是一位在肥胖和减肥维持方面颇有成就的研究人员。导师团队包括更多的教职员工，他们在以下方面拥有专业知识：将减肥计划传播到管理保健环境、医疗保健计划的成本分析、减肥的生物和生理影响，以及减肥维持试验的生物统计学和方法学方法。培训活动包括研究生课程、国家讲习班/研讨会、导师的教学指导以及参加现场跟踪/培训。这一培训计划将为应聘者提供解决一个重要研究领域的技能，因为治疗后体重恢复是常见的，而且以前的维护计划只取得了一定的成功。特别是，该奖项的研究计划包括对不同的减肥保持后续联系人时间表的影响的调查。在管理式护理环境下提供的初始减肥计划中，体重减轻5%的参与者将被随机纳入为期12个月的延长护理维持试验，包括1)集群/活动计划，或2)自我指导的比较条件。有各种经验、理论和临床证据表明，长期护理的集群/活动方法可能会改善减肥维持，尽管这种方法尚未经过经验评估。考虑到当前减肥策略的局限性，这类研究对于潜在地减少肥胖治疗后的体重恢复是新的和重要的。 公共卫生相关性： 本项目调查减肥治疗后不同的延长护理接触计划的影响，以防止治疗后体重回升。由于成功的减肥维持对许多人来说尤其具有挑战性，这项研究有可能改善肥胖干预的长期减肥结果。

DESCRIPTION (provided by applicant): The candidate for this K23 Award is a junior faculty member whose long-term goal is to have an academic research career focused on the improvement of weight loss maintenance following obesity treatment and the dissemination of research findings into applied clinical settings. In order to achieve this goal, specific training objectives for this award include: 1) develop expertise in the delivery and evaluation of extended care weight loss maintenance interventions as they are implemented in applied clinical settings (i.e., managed care), 2) develop expertise in the research methodology and statistical approach for evaluating maintenance interventions, 3) expand understanding of biological/physiological aspects of obesity and weight loss, 4) develop expertise in the evaluation of maintenance programs' cost-effectiveness, and 5) develop an R01 application to further examine innovative and effective approaches to weight loss maintenance in applied settings. To achieve these objectives, the candidate proposes a five-year training program under the primary mentorship of Dr. Michael Perri, an accomplished researcher in obesity and weight loss maintenance. The mentorship team includes additional faculty members with expertise in the dissemination of weight loss programs to managed care settings, cost analysis of healthcare programs, biological and physiological effects of weight loss, and biostatistical and methodological approaches to weight loss maintenance trials. Training activities include graduate coursework, national workshops/seminars, didactic instruction from mentors, and participation in on-site shadowing/training. This training plan will provide the candidate with the skills to address an important area of research, as weight regain following treatment is common and previous maintenance programs have achieved only modest success. In particular, the research plan for this award includes an investigation of the effects of differing schedules of follow-up contacts for weight loss maintenance. Participants achieving >5% weight loss in an initial weight loss program provided in a managed care setting will be randomized into a 12-month extended care maintenance trial, including 1) a clustered/campaign program, or 2) a self-directed comparison condition. There is a variety of empirical, theoretical, and clinical evidence to suggest that a clustered/campaign approach to extended care may improve weight loss maintenance, although this approach has not been empirically evaluated. Given the limitations associated with current weight loss maintenance strategies, such research is novel and important for potentially minimizing weight regain following obesity treatment. PUBLIC HEALTH RELEVANCE: This project examines the effects of differing schedules of extended care contact following weight loss treatment in order to prevent weight regain following treatment. Since successful weight loss maintenance is particularly challenging for many individuals, this research has the potential to improve the long-term weight loss outcomes of obesity interventions.