Efficacy of two novel behavioral post-cessation weight gain interventions

两种新颖的戒烟后体重增加行为干预措施的功效

• 批准号: 9173708
• 负责人: Rebecca A. Krukowski
• 金额: $ 69.41万
• 依托单位: UNIVERSITY OF TENNESSEE HEALTH SCI CTR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-05 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9173708
• 关键词: Attenuated; Behavior Therapy; Behavioral; Bibliotherapy; Blood Pressure; Body Weight; Body Weight Changes; Body Weight decreased; Books; Ethnic Origin; Focus Groups; Frequencies; Goals; Group Interviews; Health; Health Benefit; Individual; Intervention; Measures; Mediator of activation protein; Methods; Minority Groups; Morbidity - disease rate; Obesity; Participant; Persons; Pharmaceutical Preparations; Pharmacotherapy; Race; Randomized; Reporting; Smoker; Smoking Cessation Intervention; Translating; Treatment Efficacy; Treatment outcome; Vulnerable Populations; Weight; Weight Gain; Weight maintenance regimen; Woman; arm; base; clinically significant; computerized data processing; ethnic minority population; evidence base; follow-up; glucose metabolism; high risk; lifestyle intervention; mortality; novel; prevent; primary outcome; programs; racial minority; skills; smoking cessation; smoking relapse; varenicline; weight loss intervention; weight maintenance

While smoking cessation leads to significant improvements in mortality and morbidity, weight gain post- cessation partially attenuates this benefit. Furthermore, concerns about postcessation weight gain are common and are often cited as a reason to delay cessation attempts. In addition, postcessation weight gain is associated with smoking relapse. Thus, although the health benefits of smoking cessation outweigh the negative impact of weight gain, ideally there would be intervention “packages” that would not require that people choose between smoking cessation and nontrivial weight gain. Thus, in the proposed study, we will determine whether two very promising methods of reducing postcessation weight gain, namely a weight stability intervention (based on the evidence-based Stability Skills First intervention) versus a weight loss intervention (based on the evidence-based Look AHEAD intensive lifestyle intervention) followed by a smoking cessation intervention are efficacious for reducing postcessation weight gain. We will randomize 400 smokers to one of three arms: a) a weight stability intervention prior to cessation (STABLE); b) a weight loss intervention prior to cessation (LOSS), or c) a bibliotherapy comparison condition prior to cessation (BIBLIO) and to determine the efficacy of the interventions on preventing weight gain at 12 month follow-up. All three conditions receive a highly efficacious in-person smoking cessation behavioral intervention and six months of Varenicline (ChantixTM) pharmacotherapy. Those participants randomized to the STABLE and LOSS conditions will receive monthly booster weight management sessions, after completing the behavioral smoking cessation intervention. The primary outcomes will be weight change and smoking cessation at 12 month follow-up. In addition, we will gather process data on mediators of treatment outcome via measures of treatment engagement (e.g., session attendance, varenicline utilization). We will be able to determine whether a weight stability intervention or a weight loss intervention is efficacious in reducing post-cessation weight gain. The intervention results, if successful, could be disseminated and make a significant contribution towards curtailing obesity in this vulnerable population.

虽然戒烟能显著改善死亡率和发病率，但吸烟后体重增加。 戒烟在一定程度上削弱了这一益处。此外，对戒烟后体重增加的担忧也很常见 并经常被引用为推迟戒烟尝试的理由。此外，停药后体重增加是 与吸烟复发有关。因此，尽管戒烟对健康的好处超过了 体重增加的负面影响，理想情况下，应该有干预方案，不需要 人们在戒烟和体重增加之间做出选择。因此，在拟议的研究中，我们将 确定两种非常有希望的减少戒烟后体重增加的方法，即体重 稳定性干预(基于循证的稳定技能第一干预)与减肥 干预(基于循证的前瞻性强化生活方式干预)，然后吸烟 戒烟干预对减少戒烟后体重增加有效。我们将随机抽查400名吸烟者 以下三项中的一项：a)停止前的体重稳定干预(稳定)；b)减肥干预 停止前(丢失)，或c)停止前的阅读治疗比较情况(Biblio)和 在12个月的随访中确定干预措施对预防体重增加的效果。所有这三个条件 接受高效的面对面戒烟行为干预和六个月的瓦伦尼克林 (ChantixTM)药物疗法。那些随机进入稳定和亏损状态的参与者将 在完成行为戒烟后，每月接受助推器体重管理会议 干预。在12个月的随访中，主要结果是体重变化和戒烟。在……里面 此外，我们将通过治疗措施收集关于治疗结果中介的过程数据 参与度(例如，会议出席率、VARENICLINE使用率)。我们将能够确定一个重量是否 稳定干预或减肥干预在减少停药后体重增加方面是有效的。这个 如果成功，干预结果可以被传播，并对遏制 这一弱势群体中的肥胖问题。