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。为减少肥胖症日益流行所作的努力并不成功。美国国立卫生研究院肥胖研究战略计划提出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基于理论的干预框架内的健康促进模式（HPM）的有效性，在促进健康饮食和体育活动中的服务不足，超重或肥胖的农村妇女年龄在50-69岁的弱势群体，促进减肥和维持体重。在这些年里，妇女在绝经期和绝经后的健康风险增加，如果她们超重或肥胖，这种风险会被放大。随着年龄的增长，减肥将降低风险并增强功能状态。将强调保持体重减轻。互联网提供了一种接触孤立的农村妇女的途径，这些妇女在减肥指导方面的选择有限。将306名年龄在50-69岁之间、体重指数在28 - 39.9之间的农村妇女随机分为3组。所有参与者都将访问一个基于HPM结构的基于理论的交互式互联网网站，并讨论建议的减肥和维持健康饮食和身体活动的方法。一组将只使用互联网网站，第二组将参加补充同行领导的在线支持小组，第三组将通过电子邮件接受补充专业减肥咨询。这项研究将有3个阶段：指导性初始减肥（6个月），指导性持续减肥/维持（12个月）和自我指导的体重维持（12个月）; 30个月的时间将允许女性建立生活方式的改变，以实现体重维持。维持阶段将提供一个过渡到一个永久的健康的生活方式，在高风险的时间重新获得。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中强调的现实目标。还将检查HPM对行为特定认知/感知影响的变化，以验证干预的理论基础。如果成功的话，这项研究将对内布拉斯加州以外的农村人口产生影响，通过互联网达到减肥和维持体重的目的。

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.