Effectiveness Trial of a Dissonance-Based Obesity Prevention Program

基于失调的肥胖预防计划的有效性试验

• 批准号: 8681491
• 负责人: ERIC M STICE
• 金额: $ 58.75万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-20 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8681491
• 关键词: Age; Alcohol or Other Drugs use; Behavior; Behavioral; Body Composition; Body fat; Cognitive Dissonance; Data; Depressive disorder; Diet; Dietary intake; Eating; Eating Disorders; Educational Intervention; Elements; Energy Intake; Equilibrium; Exercise; Food; Future; Health; Hour; Hyperphagia; Incidence; Individual; Institution; Intake; Intervention; Life Style; Measures; Mediating; Mediator of activation protein; Methods; Morbidity - disease rate; Motivation; Obesity; Outcome; Output; Overweight; Pamphlets; Participant; Patient Self-Report; Persuasive Communication; Physical activity; Prevention; Prevention program; Provider; Randomized; Relative (related person); Reporting; Research; Resistance; Risk; Risk Factors; Social Psychology; Symptoms; Testing; Thinking; Thinness; Time; Weight; Weight Gain; Writing; Youth; active control; base; behavior change; body dissatisfaction; cost; depressive symptoms; design; disorder prevention; effectiveness trial; emotional eating; experience; follow-up; good diet; improved; intervention effect; mortality; novel; obesity prevention; pilot trial; preference; programs; psychologic; research study; secondary outcome; sedentary; selective prevention; success; university student; weight gain prevention; young adult

DESCRIPTION (provided by applicant): Few obesity prevention programs have reduced risk for weight gain over follow-up and those that have are very intensive (M duration = 52 hrs.), making dissemination difficult and costly. A brief 3-hr selective prevention program (Healthy Weight) involving participant-driven healthy dietary and physical activity lifestyle changes significantly reduced increases in BMI and obesity onset relative to alternative interventions and assessment- only controls through 3-yr follow-up. It targets young adults with body dissatisfaction as this is a prevalent risk factor for obesity and such individuals are motivated t make healthy lifestyle changes. To enhance efficacy, we added activities designed to induce dissonance regarding unhealthy dietary and activity practices, drawing from a highly efficacious dissonance-based eating disorder prevention program. Social psychology experiments show that people strive to maintain consistency between thoughts, words, and actions. Thus, we added verbal, written, and behavioral exercises wherein youth discuss costs of obesity, an unhealthy diet, and sedentary behaviors, benefits of leanness, a healthy diet, and physical activity, and institutions that contribute to obesity. Engaging in these activities putatively increases the likelihood that participants will seek to align their actions with the perspectives expressed in the sessions, resulting in healthier future lifestyle choices. A pilot trial found tha this new Project Health intervention significantly reduced increases in BMI relative to both the Healthy Weight intervention and an educational brochure condition from pre to post (d = .40 and .42 respectively), comparing favorably to effect sizes from the most efficacious intensive prevention programs. Further, other obesity prevention programs have not significantly outperformed credible alternative interventions. We propose to conduct a rigorous multisite effectiveness trial that will test whether adding the dissonance-induction elements to the originally efficacious Healthy Weight intervention improves weight gain prevention effects: 300 college students at risk for future unhealthy weight gain by virtue of body dissatisfaction will be randomized to a refined 8-hr dissonance-based Project Health intervention or an 8-hr Healthy Weight intervention, completing assessments of body fat and other outcomes at pre, post, and 6, 12, and 24 month follow-ups. Aim 1 will test whether Project Health reduces increases in % body fat relative to Healthy Weight; secondary outcomes are depressive and eating disorder symptoms. Aim 2 will test whether Project Health participants report cognitive dissonance regarding eating unhealthy foods and engaging in sedentary behaviors and whether changes in dissonance, as well as reported dietary intake and objectively measured activity level, mediate the effects of the intervention on change in % body fat. Aim 3 will investigate potential moderators that may amplify (pretest body dissatisfaction, preference for consistency) or mitigate (emotional eating, substance use) intervention effects. We will improve upon most obesity prevention trials by using a long-term follow-up, an active control condition, and direct measures of body composition and activity.

描述（由申请人提供）：很少有肥胖预防项目在随访中降低了体重增加的风险，而那些降低了体重增加风险的项目非常密集（M持续时间= 52小时），使得传播变得困难和昂贵。一个简短的3小时选择性预防计划（健康体重）涉及参与者驱动的健康饮食和身体活动生活方式的改变，相对于替代干预和评估，3年随访后，BMI和肥胖发生率的增加显著降低。它的目标是对身体不满的年轻人，因为这是肥胖的普遍风险因素，这些人有动力改变健康的生活方式。为了提高疗效，我们借鉴了一个高效的基于失调的饮食失调预防计划，增加了旨在诱导不健康饮食和活动习惯失调的活动。社会心理学实验表明，人们努力保持思想、言语和行动之间的一致性。因此，我们增加了口头、书面和行为练习，在这些练习中，青少年讨论肥胖的代价、不健康的饮食和久坐不动的行为、苗条的好处、健康的饮食和体育活动，以及导致肥胖的制度。参与这些活动可以增加参与者的可能性，使他们的行动与会议中表达的观点保持一致，从而选择更健康的未来生活方式。一项试点试验发现，与健康体重干预和教育宣传册条件相比，这种新的健康项目干预显著减少了体重指数的增加(d = 0.40和。（分别为42），与最有效的强化预防项目的效果相比，效果更大。此外，其他肥胖预防项目的表现并没有明显优于可靠的替代干预措施。我们建议进行一项严格的多地点有效性试验，以测试在原本有效的健康体重干预措施中加入失调诱导因素是否能提高预防体重增加的效果：300名大学生将面临由于身体不满意而导致未来不健康体重增加的风险