Cell phone Intervention Trail for Young Adults (CITY)

描述（由申请人提供）：在中年人中进行的综合试验表明，通过长期频繁的接触、频繁的自我监控、社会支持和动机咨询，可以实现并持续减肥。然而，尚不清楚这种策略是否适用于年轻人。基于生命阶段、文化背景、环境环境和市场压力，行为干预可能需要大量修改才能在年轻人中有效。要使干预对来自少数种族/族裔群体的年轻人有效，还需要更多的适应。拟议的干预措施建立在先前的证据和创新的基础上，旨在提高年轻人的有效性。在这一年龄组中使用手机进行体重控制干预具有吸引人、愉快、实用、经济、可持续和广泛传播的潜力。我们提出了一项试验，其中一项高度创新但风险更大的干预几乎完全基于手机技术的使用，另一项比传统行为干预更渐进的创新分别与常规护理对照组进行比较。我们将招募不同的超重/肥胖目标人群，一般健康的年轻人，包括约35%的非拉丁裔白人，35%的非拉丁裔黑人和30%的拉丁裔，随机分为：1)常规护理对照组：提供教育材料和信息，但不进行行为干预；2)手机干预：教育和知识与对照组相似，但此后行为干预将几乎完全通过手机进行，特别是利用手机技术的自我监控和社交网络功能；3)个人接触与手机增强：通过手机增强个人接触干预，进行自我监控。随机化后的干预期为24个月。主要结局是随机化后12个月的体重变化；一个重要的次要结果是24个月时的体重变化。形成阶段将主要集中于技术/干预措施的发展。

DESCRIPTION (provided by applicant): Composite Trials in middle aged adults indicate that weight loss can be achieved and sustained with frequent contact over a long period of time, frequent self-monitoring, social support and motivational counseling. However, it is unclear whether this strategy would work in younger adults. Based on life stage, cultural context, environmental circumstances, and marketing pressures, behavioral Intervention may need to be substantially modified to be effective in young adults. Even more adaptation will be required for intervention to be effective in young adults from racial/ethnic minority groups. The proposed intervention builds on prior evidence with innovations directed at increasing effectiveness in young adults. Using cell phones to deliver a weight control intervention in this age group has the potential to be engaging, enjoyable, practical, cost-effective, sustainable, and broadly disseminated. We propose a trial in which a highly innovative but more risky intervention based almost entirely on use of cell phone technology and a second more incremental innovation over traditional behavioral intervention are each compared to a usual care control group. We will recruit a diverse target population of ovenweight/obese, generally healthy young adults, comprising approximately 35% non-Latino Whites, 35% non-Latino Blacks, and 30% Latinos, to be randomized to: 1) Usual care control: Educational materials and information but no behavioral intervention; 2) Cell-phone intervention: similar education and knowledge as the control group, but thereafter a behavioral intervention will be delivered almost exclusively via cell phone, particularly using the self-monitoring and social networking features of this technology; 3) Personal contact with cell-phone enhancement: personal contact intervention enhanced by cell-phone for self-monitoring. The post-randomization intervention period will last 24 months. The primary outcome is change in weight 12 months post-randomization; an important secondary outcome is weight change at 24 months. The formative phase will focus largely on technology/intervention development. RELEVANCE (See instructions): The obesity epidemic is affecting young adults, leading to increased risk of diabetes, high blood pressure, and cardiovascular disease. Based on life stage, cultural context, environmental circumstances, and marketing pressures, behavioral intervention may need to be substantially modified to be effective in young adults, espcially young minorities. Using cell phones to deliver a weight control intervention has the potential to be engaging, enjoyable, practical, cost-effective, (End of Abstract)