Study of Novel Approaches to Weight Gain Prevention - Extension (SNAP-E)

预防体重增加新方法的研究 - 扩展 (SNAP-E)

• 批准号: 8985911
• 负责人: MARK Andrew ESPELAND
• 金额: $ 77.35万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8985911
• 关键词: Address; Adopted; Age; Behavior; Behavioral; Body Composition; Body Weight Changes; Buffers; Categories; Characteristics; Clinic; Communication; Comorbidity; Control Groups; Data; Data Collection; Diet; Dietary intake; Eating; Effectiveness of Interventions; Event; Exercise; Frequencies; Future; Goals; Grant; Health; Informal Social Control; Intervention; Life; Lipids; Measures; Modeling; Obesity; Outcome; Overweight; Participant; Pattern; Physical activity; Pregnancy; Prevention trial; Preventive Intervention; Probability; Procedures; Public Health; Questionnaires; Randomized Clinical Trials; Randomized Controlled Clinical Trials; Relative (related person); Risk; Risk Factors; S-nitro-N-acetylpenicillamine; Subgroup; Technology; Time; Weight; Weight Gain; Weight maintenance regimen; age group; arm; base; cardiovascular disorder risk; cohort; cost; cost effective; effective intervention; experience; follow-up; glucose metabolism; innovation; intervention effect; novel strategies; prevent; public health relevance; response; skills; success; weight gain prevention; young adult

 DESCRIPTION (provided by applicant): This application seeks to follow the participants in Study of Novel Approaches to Weight Gain Prevention (SNAP) (Grant #U01-HL090864), a randomized clinical trial that has successfully reduced weight gain in young adults through 3 years. SNAP is the first weight gain prevention trial to show positive effects over an extended time period in this age group. The SNAP-Extension (SNAP-E) will cost-effectively determine whether the effects of the intervention can be maintained over 3 additional years (through a total of 6 years). Young adults, ages 20-35, gain on average 2 pounds per year, increasing their risk of developing obesity and obesity related co-morbidities. Previous efforts to prevent this weight gain have had limited success. SNAP is a randomized controlled clinical trial involving 599 participants, age 18-35 with a BMI of 23- 30, comparing weight changes over an average follow-up of 3 years in a control group and two innovative interventions. Both interventions are based on a self-regulation model, involving frequent self-weighing and changes in eating and activity if weight gain occurs. However, one intervention focuses on making small consistent changes in eating and exercise behavior to prevent weight gain; the other emphasizes periodic larger changes in eating and exercise, with a goal of producing a buffer against anticipated weight gains. SNAP has had excellent retention to date and has shown that both interventions significantly reduced weight gain relative to control through 3 years. Although weight changes in the two interventions do not differ from each other at 3 years, they have had very different weight change trajectories, raising questions about long- term efficacy. Continuing to follow these participants is critical to determine whether the skills imparted during these interventions and the resulting beneficial effects on weight gain are maintained longer term and whether there are differences in outcomes for large and small change approaches. In SNAP-E we will provide minimal intervention for the Small and Large Change groups using remote technology and will follow all participants at 6 month intervals using Smart Scales and on-line questionnaires. There will be one final clinic assessment at Year 6, with measures of body composition, cardiovascular disease (CVD) risk factors, dietary intake and objective assessment of physical activity, all implemented using procedures that were used throughout SNAP. The primary hypothesis of SNAP-E is that the magnitude of weight gain from baseline to 6 years will differ among the three arms. Secondary hypotheses compare the groups on dichotomous measures of weight gain, on CVD risk factors, and on weight control behaviors. Preventing weight gain may be a more effective public health approach than treating obesity. SNAP is the first study to show long-term benefits of an intervention on weight gain in young adults. Continuing to follow these participants in SNAP-E provides a cost-effective and unique opportunity to answer important questions about weight gain prevention.

 描述（由申请人提供）：本申请旨在跟踪体重增加预防新方法研究（SNAP）（资助编号U 01-HL 090864）的参与者，该随机临床试验已成功减少年轻人的体重增加3年。SNAP是第一个在这个年龄组中长时间显示积极效果的体重增加预防试验。SNAP-E将以成本效益高的方式确定干预措施的效果是否可以再维持3年（总共6年）。20-35岁的年轻人平均每年增加2磅，增加了他们患肥胖症和肥胖相关并发症的风险。以前为防止体重增加所做的努力成效有限。SNAP是一项随机对照临床试验，涉及599名参与者，年龄在18-35岁之间，BMI为23- 30，比较对照组和两种创新干预措施在平均3年随访期间的体重变化。这两种干预措施都是基于自我调节模型，包括频繁的自我称重以及在体重增加时改变饮食和活动。然而，一种干预措施的重点是在饮食和运动行为方面进行小的一致性改变，以防止体重增加;另一种干预措施强调饮食和运动的周期性较大变化，目的是对预期的体重增加产生缓冲。迄今为止，SNAP具有良好的保持力，并且表明两种干预措施在3年内相对于对照组显著降低了体重增加。虽然这两种干预措施的体重变化在3年时没有差异，但它们的体重变化轨迹却有很大不同，这引发了对长期疗效的质疑。继续跟踪这些参与者对于确定在这些干预期间传授的技能以及由此产生的对体重增加的有益影响是否能够长期保持以及大变化和小变化方法的结果是否存在差异至关重要。在SNAP-E中，我们将使用远程技术为小变化和大变化组提供最小干预，并将使用智能量表和在线问卷每6个月对所有参与者进行一次随访。在第6年将进行一次最终临床评估，测量身体成分，心血管疾病（CVD）风险因素，饮食摄入量和身体活动的客观评估，所有这些都使用在整个SNAP中使用的程序实施。SNAP-E的主要假设是，从基线到6年的体重增加幅度在三个组中不同。次要假设比较了体重增加、心血管疾病危险因素和体重控制行为的二分指标。预防体重增加可能是比治疗肥胖更有效的公共卫生方法。SNAP是第一项显示干预对年轻人体重增加的长期益处的研究。继续跟踪SNAP-E中的这些参与者提供了一个具有成本效益和独特的机会来回答有关预防体重增加的重要问题。