Recruiting and Retaining Young Adults in Behavioral Weight Loss Treatment

描述(由申请人提供)： 这项以患者为导向的指导研究职业奖(K23)的目标是让Gokee-LaRose博士成为一名独立的研究员，专注于开发干预措施，以针对过渡到年轻人期间的可改变的心血管疾病风险因素。通过授课和直接指导的培训经验，这项培训计划将使她在以下方面发展技能和专长：1)设计和实施随机临床试验(重点是肥胖)；2)定性研究方法，使她能够有效地为年轻人量身定做计划；3)增加与年轻人相关的心血管疾病风险因素的知识，以及用于评估随机对照试验新标记物的方法；以及4)研究伦理和分析随机对照试验产生的数据所需的高级统计技能。米里亚姆医院/布朗医学院的资源以及与她的专家导师团队(Wing博士、Jelian博士、Morrow博士、Lewis博士和Fava博士)的密切联系将为她提供实现培训和研究目标的理想环境。18至25岁的年轻人体重增加和肥胖的风险特别高；然而，他们在标准项目中的代表性不足，而且几乎不知道如何最好地招募和/或留住这一群体接受治疗。我们的试验数据表明，通过对年轻人进行简短的、基于临床的计划，可以实现显著的减肥，并在短期内保持下去。这项建议的目标有两个：1)进行旨在改善该年龄段招募和留住工作的形成工作，2)进行随机临床试验，以测试三种不同方法在较长期体重控制方面的可行性和初步效果。在第一阶段，80名18-25岁的超重或肥胖男性和女性将参加焦点小组，以解决招募、留住和治疗障碍问题。在第二阶段，一个由90名参与者组成的新样本将被登记参加一个简短的、为期10周的BWL计划，然后在12个月内随机分配到三个维护小组中的一个。联系时间表和交付形式将部分由第一阶段决定；三个分支将继续面对面、时事通讯控制或另一种形式的继续联系。评估将在基线、10周、6个月和12个月进行。 与公共健康相关：在美国，肥胖症已经达到了流行的程度，18岁至25岁的年轻人面临着特别高的风险；然而，到目前为止，标准的行为减肥计划还没有成功地接触到这一高危群体。目前尚不清楚如何在最初最好地招募这些人接受治疗，或者如何在长期内将他们留在治疗中。拟议的研究填补了这一空白，因此将对临床和公共卫生产生重大影响。

DESCRIPTION (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Award (K23) is to allow Dr. Gokee-LaRose to become an independent investigator focused on developing interventions to target modifiable CVD risk factors during the transition into young adulthood. This training plan, through didactic and direct mentored training experiences, will allow her to develop skills and expertise in: 1) design and conduct of randomized clinical trials (with an emphasis on obesity); 2) qualitative research methods, which will enable her to effectively tailor programs for young adults; 3) increased knowledge of CVD risk factors with relevance to young adults and methodology used to assess novel markers in RCTs; and 4) research ethics and the advanced statistical skills needed to analyze data resulting from RCTs. The resources at the Miriam Hospital/ Brown Medical School and close contact with her expert mentor team (Drs. Wing, Jelalian, Morrow, Lewis and Fava) will provide her with the ideal environment to achieve her training and research goals. Young adults between 18 and 25 are at particularly high risk for weight gain and obesity; yet, they are under-represented in standard programs and little is known about how best to recruit and/or retain this group in treatment. Our pilot data indicates significant weight losses can be achieved through a brief, clinic-based program with young adults, and maintained in the short-term. The goal of this proposal is twofold: 1) to conduct formative work aimed at improving recruitment and retention efforts with this age group, and 2) to conduct a randomized clinical trial to test the feasibility and preliminary efficacy of three different approaches to longer-term weight control. In Phase 1, 80 overweight or obese men and women ages 18-25 will participate in focus groups to address recruitment, retention and barriers to treatment. In Phase 2, a new sample of 90 participants will be enrolled in a brief, 10-week BWL program and then randomized to one of three maintenance arms through 12 months. Contact schedule and delivery format will be determined in part by Phase 1; the three arms will be continued face-to-face, a newsletter control, or an alternative form of continued contact. Assessments will take place at baseline, 10 weeks, 6 and 12 months. PUBLIC HEALTH RELEVANCE: Obesity has reached pandemic proportions in the United States, and young adults between 18 and 25 are at particularly high risk; yet to date, standard behavioral weight loss programs have not been successful at reaching this high-risk group. It remains unclear how best to recruit these individuals for treatment initially, or how to retain them in treatment in the longer-term. The proposed research fills this gap, and therefore stands to have substantial clinical and public health implications.