Test of a theory-based weight loss program for couples: Project TEAMS

针对夫妻的基于理论的减肥计划的测试：Project TEAMS

• 批准号: 8792471
• 负责人: Amy A Gorin
• 金额: $ 24.07万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2016-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8792471
• 关键词: Address; Adult; Attention; Behavior; Behavior Therapy; Behavioral; Body Weight Changes; Body Weight decreased; Child; Competence; Couples; Decision Making; Development; Diet; Diet Habits; Eating; Educational process of instructing; Environment; Family; Funding; Future; Health; Health Personnel; Health behavior; Health behavior change; Home environment; Individual; Informal Social Control; Intervention; Intervention Studies; Joints; Knowledge; Link; Literature; Maintenance; Marriage; Measures; Mediating; Modeling; Motivation; Obesity; Outcome; Physical activity; Plant Roots; Process; Publishing; Qualifying; Randomized; Randomized Controlled Trials; Research; Running; Self Determination; Social Environment; Spouses; Testing; Time; Training; Treatment outcome; Weight; Weight Gain; Weight maintenance regimen; Work; base; behavior change; brief intervention; collaborative environment; design; energy balance; follow-up; improved; neglect; obesity risk; obesity treatment; prevent; programs; public health relevance; satisfaction; skills; social; theories; therapy design; transmission process; treatment adherence; treatment program; weight maintenance

DESCRIPTION (provided by applicant): Obesity runs in families - spouses enter marriage with similar weight statuses, gain weight together over time and model obesogenic behaviors for their children. Many energy balance decisions are made in the home and this important social/interpersonal environment can either help or hinder weight management. Ecological models of obesity recognize the impact of the home and larger environment contexts on weight, however, existing treatment models remain individual-focused. Weight loss outcomes might be improved by expanding the focus of treatment from the individual to the marital dyad, targeting joint behavior change and the creation of an interpersonal milieu that supports long-term behavior change. According to Self Determination Theory, greater autonomous self-regulation of behaviors and subsequently better treatment outcomes are observed when individuals have important others in their lives who provide an environment in which personally meaningful choice is supported and criticism and control are minimized. Previous research including our own ongoing work suggests that increases in autonomy support from important others are associated with increases in autonomous self-regulation for weight loss and that these changes in autonomous self-regulation are indeed associated with weight loss outcomes. Additional research is needed to establish causal links and to develop and test interventions designed to facilitate the autonomy supportive behavior of significant others in the home environment. This theoretically based approach has tremendous potential to add to the modest effects found in the published literature on the involvement of spouses in weight loss treatment. The proposed study is a randomized controlled trial testing a couple's intervention based on Self Determination Theory that is designed to change the social context of weight loss by training spouses to provide autonomy support for each other's eating and physical activity behavior change. Sixty-four couples will be randomized to either 6 months of treatment based on SDT (SDT-WL) or to 6 months of treatment based on behavioral theory (BWL). Couples will attend weekly sessions for 6 months and will be assessed at 0, 6, and 12 months. We predict that by bolstering autonomy support, SDT-WL will increase autonomous self-regulation and perceived competence and will produce greater weight loss and maintenance than standard behavioral treatment. The study focuses on couples rather than individuals, is theoretically based, focusing on autonomy support and distinguishing this from other types of support, and directly trains partners in such supportive behaviors. If successful, we will seek funding to test the SDT approach in a larger trial with a longer follow-up period.

描述（由申请人提供）：肥胖在家庭中遗传——配偶以相似的体重状况结婚，随着时间的推移体重增加，并为孩子树立肥胖行为的榜样。许多能量平衡决策都是在家里做出的，这种重要的社交/人际环境可以帮助或阻碍体重管理。肥胖的生态模型认识到家庭和更大的环境背景对体重的影响，然而，现有的治疗模型仍然以个人为中心。通过将治疗重点从个人扩大到婚姻夫妻、针对共同行为改变以及创建支持长期行为改变的人际环境，可以改善减肥结果。根据自我决定理论，当个人生活中有重要的其他人提供一个支持个人有意义的选择并最大限度地减少批评和控制的环境时，就会观察到更大的自主行为自我调节以及随后更好的治疗结果。包括我们自己正在进行的工作在内的先前研究表明，来自重要他人的自主支持的增加与减肥的自主自我调节的增加有关，并且自主自我调节的这些变化确实与减肥结果相关。需要进行更多研究来建立因果联系，并开发和测试旨在促进家庭环境中重要他人的自主支持行为的干预措施。这种基于理论的方法具有巨大的潜力，可以增加已发表的关于配偶参与减肥治疗的文献中发现的适度效果。拟议的研究是一项随机对照试验，测试基于自我决定理论的夫妇干预措施，该理论旨在通过训练配偶为彼此的饮食和身体活动行为改变提供自主支持来改变减肥的社会背景。 64 对夫妇将被随机分配接受 6 个月的基于 SDT (SDT-WL) 的治疗或 6 个月的基于行为理论 (BWL) 的治疗。夫妇将参加为期 6 个月的每周课程，并将在 0、6 和 12 个月时进行评估。我们预测，通过加强自主支持，SDT-WL 将增强自主自我调节和感知能力，并将比标准行为治疗产生更大的减肥效果和维持效果。该研究以夫妻而非个人为对象，以理论为基础，重点关注自主支持并将其与其他类型的支持区分开来，并直接培训伴侣进行此类支持行为。如果成功，我们将寻求资金，在更大规模的试验中测试 SDT 方法，并进行更长的随访期。