Web-Based Weight Loss & Weight Maintenance for Older Rural Women

描述（由申请人提供）：根据美国国立卫生研究院，“肥胖是21世纪最令人生畏的健康挑战之一”。大约三分之二的成年人超重或肥胖。为减少日益普遍的肥胖所做的努力并没有取得成功。美国国立卫生研究院肥胖研究战略计划建议通过改变生活方式来预防和治疗肥胖。本研究的目的是评估健康促进模型（HPM）框架内基于理论的干预措施的有效性，通过促进健康饮食和体育活动，促进50-69岁农村妇女超重或肥胖的弱势群体的体重减轻和维持。在这些年中，妇女在绝经前后的健康风险增加，如果她们超重或肥胖，这种风险就会放大。随着年龄的增长，减肥可以降低风险，增强身体机能。将强调减肥的维持。互联网为孤立的农村妇女提供了一种途径，她们在减肥指导方面的选择有限。将306名年龄在50-69岁、身体质量指数28 - 39.9的农村妇女随机分为3组。所有参与者都将访问一个基于理论的交互式互联网网站，该网站基于HPM的构建，并介绍了减肥和维持体重的健康饮食和体育活动的推荐方法。其中一组将只使用互联网网站，第二组将参加一个补充性的由同行领导的在线支持小组，第三组将通过电子邮件获得补充性的专业减肥咨询。本研究将分为3个阶段：指导下的初始减肥（6个月），指导下的持续减肥/维持（12个月）和自我指导的体重维持（12个月）；在这30个月的时间里，女性将有时间改变生活方式来维持体重。维持阶段将提供一个过渡到一个永久的健康的生活方式，在高风险的恢复。主要结果将是在3、6、12、18、24和30个月时体重、饮食和活动的变化。至少5%，最好是10%的体重减轻而不反弹将是本研究强调的现实目标。HPM对行为特定认知/知觉影响的改变也将被检验，以验证干预的理论基础。如果成功，这项研究将对内布拉斯加州以外的农村人口通过互联网减肥和维持体重产生影响。

DESCRIPTION (provided by applicant): According to the National Institutes of Health, "obesity is one of the most daunting health challenges of the 21st century". Approximately 2/3 of all adults are overweight or obese. Efforts to abate the growing prevalence of obesity have not been successful. The Strategic Plan for NIH Obesity Research proposes preventing and treating obesity through lifestyle modification. The purpose of this study is to evaluate the effectiveness of a theory-based intervention framed within the Health Promotion Model (HPM) in facilitating weight loss and maintenance through promotion of healthy eating and physical activity among an underserved, vulnerable population of overweight or obese rural women aged 50-69. During these years, women experience increases in peri- and post-menopausal health risks that are magnified if they are overweight or obese. Weight loss will reduce risks and enhance functional status as they age. Maintenance of weight loss will be emphasized. The Internet offers a way to reach isolated rural women who have limited options for weight loss guidance. A convenience sample of 306 rural women age 50-69 with body mass index 28 to 39.9 will be randomized into 3 groups. All participants will access a theory-based interactive Internet site based on constructs in the HPM and addressing recommended approaches to healthy eating and physical activity for weight loss and maintenance. One group will use the Internet site only, a second group will participate in a supplemental peer-led online support group, and a third group will receive supplemental professional weight loss counseling via e-mail. This study will have 3 phases: guided initial weight loss (6 months), guided continuing weight loss/maintenance (12 months) and self-directed weight maintenance (12 months); the 30-month period will allow time for women to establish lifestyle changes to achieve weight maintenance. The maintenance phases will provide a transition to a permanent healthy lifestyle during the time of high risk for regain. The primary outcomes will be change in body weight, eating, and activity at 3, 6, 12, 18, 24, & 30 months. At least 5% and preferably 10% of loss of weight without regain will be the realistic targets emphasized in this study. Change in behavior-specific cognitive/ perceptual influences from the HPM also will be examined to validate the theory base for the intervention. If successful, this research study will have implications beyond Nebraska for reaching rural populations through the Internet for weight loss and maintenance.