Families Improving Together (FIT) For Weight Loss

描述（由申请人提供）：肥胖率的上升已经成为一个主要的公共卫生问题，全国报告表明40%的非裔美国青少年现在超重或肥胖。对少数民族青少年的有效减肥干预知之甚少。在某种程度上，这是因为研究表明，与白种人相比，少数民族参加的干预课程更少，损耗率更高，体重减轻得更少。与缺乏进展相关的两个基本问题是：1)缺乏针对非裔美国青少年的减肥干预措施的适当内容，这些干预措施整合了文化问题、养育技能和长期改变的激励策略；2)由于参与者疲劳和退出，减肥干预措施的剂量不足。以前的青少年减肥研究持续时间相对较长，持续时间为12-25周，然而，我们的团队开发了一个减肥计划，这是一个相对简短（8周）的面对面干预，整合了动机（自主支持）和积极的育儿技巧（监测，社会支持，积极的沟通技巧），以降低超重的非裔美国青少年的z-BMI。我们的团队最近还进行了一项试点研究，测试为非裔美国家庭量身定制的为期8周的在线干预的可行性。因此，本项目的目标是进行一项随机对照疗效试验，以解决过去研究中的问题：1)缩短面对面小组干预时间；2)使用在线组件来补充以小组为基础的干预以增加剂量；3)根据父母和青少年的技能水平和文化背景，直接定制动机和育儿技能计划。520名超重的非裔美国青少年和他们的父母将被招募参与。试验的第一阶段将测试一项为期8周的面对面小组随机试验的有效性，比较动机加家庭减肥（M+FWL）和基本健康（BH）教育计划在降低z-BMI和改善饮食和体育活动（PA）方面对超重的非裔美国青少年的影响。在第二阶段的试验中，参与者将被重新随机分配到8周的在线干预或对照在线计划中，结果是2 （M+FWL组vs. BH组）x 2（干预组vs.对照在线计划）的因子设计。本设计将允许我们测试M+FWL课程的效果以及在线干预组件对降低非裔美国青少年及其父母的z-BMI的附加效果。为期6个月的随访将检查8周M+FWL组加上8周在线干预计划的青少年是否在降低z- BMI方面表现出最大的维持。将检查治疗效果的社会心理介质以及与父母z-BMI和健康行为（饮食和PA）变化相关的治疗效果。

DESCRIPTION (provided by applicant): The increasing rate of obesity has become a major public health concern with national reports indicating 40% of African American adolescents are now overweight or obese. Little is known about effective weight loss interventions in ethnic minority adolescents. In part, this is because research has shown that ethnic minorities attend fewer intervention sessions, have higher attrition rates and lose less weight compared to Caucasians. Two fundamental problems related to this lack of progress are 1) the lack of appropriate content of weight loss interventions for African American adolescents that integrate cultural issues, parenting skills, and motivational strategies for long-term change and, 2) the poor dose of weight loss interventions because of participant fatigue and drop out. Previous weight loss studies among adolescents have been of relatively long duration lasting 12-25 weeks, however, our team has developed a weight loss program that is a relatively brief (8-week brief) face-to-face intervention that integrates motivational (autonomy-support) and positive parenting skills (monitoring, social support, positive communication skills) for reducing z-BMI in overweight African American adolescents. Our team has also recently conducted a pilot study testing the feasibility of an 8-week on-line intervention that is culturally tailored fr African American families. Thus, the goal of this project is to conduct a randomized controlled efficacy trial to address the problems with past studies by 1) making the face-to-face group intervention shorter, 2) using an on-line component to compliment the group- based intervention for increasing dose, and by 3) tailoring a motivational and parenting skills program directly to parents and adolescents skill levels and cultural background. 520 overweight African American adolescents and their parents will be recruited to participate. Phase I of the trial will test the efficacy of an 8-week face-to-face group randomized trial comparing motivational plus family-based weight loss (M+FWL) to a basic health (BH) education program on reducing z-BMI and improving diet and physical activity (PA) in overweight African American adolescents. In phase II of the trial participants will be re-randomized to either an 8-week on-line intervention or a control on-line program resulting in a 2 (M+FWL vs. BH group) x 2 (intervention vs. control on-line program) factorial design. This design will allow us to test the effects of the M+FWL curriculum and the added effects of the on-line intervention component on reducing z-BMI in African American adolescents and their parents. A 6-month follow-up will examine whether adolescents in the 8-week M+FWL group plus 8-week on-line intervention program will show the greatest maintenance in reducing z- BMI. Psychosocial mediators of treatment effects will be examined as well as treatment effects related to parent changes in z-BMI and health behaviors (diet and PA).