Enhancing Effectiveness of a Dissonance-Based Obesity Prevention Program

提高基于失调的肥胖预防计划的有效性

基本信息

批准号：
9581127
负责人：
ERIC M STICE
金额：
$ 66.34万
依托单位：
OREGON RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-18 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9581127
关键词：
20 year old Adolescence Adolescent Attention Attitude Attitude to Health Behavior Calories Computers Cues Development Dietary intake Eating Disorders Education Effectiveness Epidemic Equilibrium Exercise Exhibits Expenditure Fatty acid glycerol esters Female Food Functional Magnetic Resonance Imaging Future Generic Drugs Goals Health Hyperphagia Image In complete remission Intake Intervention Investigational Therapies Life Style Mediating Morbidity - disease rate Neurosciences Obesity Outcome Overweight Palate Participant Physical activity Prevalence Prevention Prevention program Procedures Randomized Reporting Rewards Risk Signal Transduction Testing Thinness Training Unhealthy Diet Weight Gain Youth attentional bias base behavioral response cohesion combat cost diet and exercise energy balance evidence base executive function follow-up good diet improved intervention effect male mortality novel obesity prevention pilot trial prevent programs randomized trial relating to nervous system response sedentary lifestyle sex therapy design visual search weight gain prevention willingness to pay

项目摘要

ABSTRACT Prevention is key for combating obesity, but few programs have prevented future increases in BMI and onset of overweight/obesity, particularly during late adolescence when youth often assume responsibility for dietary intake and exercise choices. One exception is a brief 6-hr dissonance-based program (Project Health) wherein participants make small lasting incremental lifestyle changes to dietary intake and exercise to reach energy balance, and discuss costs of obesity, an unhealthy diet, and sedentary behavior, and benefits of leanness, a healthy diet, and exercise, which prompts them to align their attitudes with their publically displayed behavior. These activities promote internalization of health goals and executive control over lifestyle behaviors. Late adolescents randomized to Project Health showed less increases in BMI and a 41% and 43% reduction in overweight/obesity onset over 2-yr follow-up compared to a version of the program lacking dissonance- induction activities and an obesity education condition. Project Health appears to be the first program to produce these key obesity prevention effects relative to an alternative intervention, but it is critical to increase effects. A dissonance-based prevention program was more effective when implemented in single- versus mixed-sex groups, theoretically because it promoted greater participation in dissonance-inducing discussions. Aim 1a is to test whether the weight gain prevention effects will be larger when Project Health is implemented in single-sex groups; we will randomize 450 17-20 year olds to complete Project Health in female, male, or mixed-sex groups, assessing outcomes at pretest, posttest, and 6, 12, 24, and 36-month follow-ups. Aim 1b is to test whether greater participation in dissonance-inducing discussions and group cohesion mediate the effect of condition on any superior weight gain prevention effects. Adolescents who show greater fMRI-assessed reward and attention region responsivity to food images exhibit elevated future weight gain, implying that reducing this responsivity may reduce future weight gain. In a pilot trial, late adolescents who completed go/no- go, stop-signal, and respond-signal computer training in which they repeatedly inhibit responses to high-calorie foods and respond to low-calorie foods, and dot-probe and visual-search computer tasks that train attention away from high-calorie foods and to low-calorie foods, showed a greater reduction in reward and attention region responsivity to, palatability rating of, and willingness to pay for, high-calorie foods, suggesting reduced valuation and attentional bias, as well as greater fat loss over 1-yr follow-up versus controls who completed the training with non-food images. Aim 2a is to test whether adding food response and attention training to Project Health will produce larger weight gain prevention effects. Participants in the 3 conditions will be randomized to complete response and attention training for 25-mins after each of the 6-sessions with either food or non-food images. Aim 2b is to test whether reduced palatability ratings of, willingness to pay, and attentional bias for high-calorie foods mediate the effect of training condition on any superior weight gain prevention effects.

抽象的预防是打击肥胖的关键，但是很少有计划阻止BMI和发作的未来增加超重/肥胖症，尤其是在青春期后期，年轻人经常承担饮食责任摄入和运动选择。一个例外是一个简短的基于6小时失调的计划（项目健康）参与者对饮食摄入量和运动的持久生活方式进行了持久的增量生活方式，以达到能量平衡并讨论肥胖的成本，不健康的饮食和久坐的行为以及瘦身的好处，健康的饮食和运动，这促使他们与公开显示的行为保持一致。这些活动促进了健康目标的内在化和对生活方式行为的执行控制。晚的随机分配项目健康的青少年显示BMI的增加较少，减少了41％和43％与缺乏不和谐的程序相比，超重/肥胖的开始超过2年的随访归纳活动和肥胖教育条件。项目健康似乎是第一个计划相对于替代干预产生这些关键的肥胖预防效果，但要增加至关重要效果。单一实施时，基于不和谐的预防计划更有效从理论上讲，混合性群体是因为它促进了引起不和谐的讨论的更多参与。 AIM 1A是测试实施项目健康后，预防体重增加的效果是否会更大在单性别组中；我们将随机分配450名17-20岁的孩子，以完成女性，男性或混合性组，评估预测试，后测和6、12、24和36个月的随访。 AIM 1B是测试是否有更多参与不和谐的讨论和群体凝聚力介导了效果对任何超级体重增加的预防效果的条件。表现出更大fmri评估的青少年奖励和注意区域对食物图像的反应表现出升高的未来体重增加，这意味着降低这种响应能力可能会减少未来的体重增加。在试点审判中，完成GO/NO-的晚期青少年去，停止信号和反应信号计算机培训，他们反复抑制对高热量的反应食物并响应低热量食品，以及培训注意力的点探针和视觉搜索计算机任务远离高热量食品和低热量食品，奖励和关注的降低更大区域对高热量食品的响应，可口的评级和愿意支付的意愿，建议减少估值和注意力偏见，以及完成1年的随访与完成的对照组的脂肪损失更大使用非食品图像进行培训。 AIM 2A是测试是否添加食物反应和注意力培训健康将产生更大的体重增加预防效果。在这3个条件下的参与者将随机分配给每六个课程中的25分钟的完全反应和注意力训练都用食物或非食物图像。 AIM 2B是测试是否降低了对可口的评级，付款意愿和注意力的偏见高热量食品介导训练条件对任何出色体重增加的预防影响的影响。