Log2Lose: Incenting weight loss and dietary self-monitoring in real-time to improve weight management

Log2Lose：激励减肥和实时饮食自我监控，以改善体重管理

• 批准号: 10850242
• 负责人: Corrine Ione Voils
• 金额: $ 9.25万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10850242
• 关键词: Address; Adult; Algorithms; Behavioral; Body Weight decreased; Cellular Phone; Clinical; Clinical Trials; Communities; Computer software; Data; Diet; Educational process of instructing; Funding; Goals; Health; Health behavior and outcomes; Incentives; Individual; Intervention; Intervention Trial; Interview; Joints; Maintenance; Measures; Mediating; Mentorship; Monitor; Obesity; Outcome; Participant; Patients; Persons; Phase; Population; Prevalence; Process; Program Effectiveness; Publications; Quality of life; Randomized; Research Training; Role; Single-Blind Study; Site; Technology; Testing; Text Messaging; Time; Weight; Weight maintenance regimen; Writing; clinically significant; cohort; cost; cost effective; cost effectiveness; cost-effectiveness ratio; design; dietary; evidence base; experience; extrinsic motivation; falls; financial incentive; four-arm study; graduate medical education; improved; intervention cost; intervention effect; intrinsic motivation; male; men; parent grant; payment; primary endpoint; program costs; programs; recruit; weight loss intervention; weight loss program; weight maintenance

Abstract In the past 40 years, the prevalence of obesity has increased at an alarming rate. Even modest weight loss of at least 5% improves clinical parameters and quality of life. Efficacious behavioral weight loss programs teach participants behavioral strategies to create and maintain a caloric deficit. The two strongest predictors of long- term weight loss in such programs are initial weight loss and dietary self-monitoring. Over time, these phenomena decline, limiting program effectiveness. Financial incentives to increase initial weight loss and self- monitoring are appealing because they can be delivered to large populations with relative ease and at low cost. Employers and payers have begun to provide financial incentives for health behaviors and outcomes despite an inadequate evidence base to inform the optimal design of such interventions. The proposed study will evaluate which incentive approach has the greatest impact and durability—incentivizing interim weight loss, dietary self-monitoring, or both. Studies testing the effects of incentivizing these phenomena have showed some promise for increasing short-term weight loss. Few studies have evaluated incentive effects on long-term weight loss; examined the mediating role of intrinsic or extrinsic motivation; or calculated program costs or cost-effectiveness of financial incentive interventions. In the proposed two-site, randomized, single-blinded, longitudinal 2x2 factorial study, known as “Log2Lose,” we address these limitations by evaluating the individual and joint effects of incentivizing, in near real-time, weekly weight loss and dietary self-monitoring on 6-month weight loss and subsequent weight loss maintenance. People with obesity from the communities of Madison, WI and Durham, NC will receive an 18-month intervention comprising: 1. An incentivized weight loss program for 6 months (Phase I), 2. An incentivized weight maintenance program for 6 months (Phase II), and 3. A non- incentivized weight maintenance program for 6 months (Phase III). Participants will be randomized to receive adjunctive incentives for weekly weight loss, dietary self-monitoring, both, or neither. We will measure the proportion of participants achieving clinically significant weight loss of ≥5% at 6 (primary endpoint), 12, and 18 months. We will assess whether extrinsic and intrinsic motivation mediate intervention effect; calculate intervention costs; and calculate cost-effectiveness ratios across the four study arms. Our financial incentives intervention was designed to be scalable by using available technology and automating the process of analyzing data to provide incentives in near real-time. The intervention could be paired with various weight loss interventions offered by clinicians or payers, or integrated into a variety of patient and consumer-facing technologies. Completion of this study will contribute to our long-term goal of identifying and implementing efficacious, cost-effective, scalable approaches to reduce the prevalence of obesity and associated health outcomes.

抽象的 过去40年来，肥胖症患病率以惊人的速度增加。即使是适度的减肥 至少 5% 改善临床参数和生活质量。有效的行为减肥计划教授 参与者创造和维持热量赤字的行为策略。长期的两个最强预测因素 此类计划中的术语减肥是初始减肥和饮食自我监控。随着时间的推移，这些 现象下降，限制了计划的有效性。增加初始减肥和自我减肥的经济激励 监测之所以有吸引力，是因为它们可以相对容易且成本低廉地向大量人群提供。 雇主和付款人已开始为健康行为和结果提供经济激励，尽管 证据基础不足，无法为此类干预措施的最佳设计提供信息。拟议的研究将 评估哪种激励方法具有最大的影响力和持久性——激励临时减肥， 饮食自我监测，或两者兼而有之。测试激励这些现象的效果的研究表明 一些承诺可以增加短期减肥效果。很少有研究评估激励对长期的影响 减肥；检查内在或外在动机的中介作用；或计算出的计划成本或 财政激励干预措施的成本效益。在拟议的两中心、随机、单盲试验中， 纵向 2x2 因子研究，称为“Log2Lose”，我们通过评估个体来解决这些局限性 近实时每周减肥和 6 个月饮食自我监测激励的联合效应 减肥和随后的减肥维持。来自麦迪逊社区的肥胖者， 威斯康星州和北卡罗来纳州达勒姆将接受为期 18 个月的干预，包括： 1. 激励减肥计划 6 个月（第一阶段）， 2. 为期 6 个月的激励性体重维持计划（第二阶段），以及 3. 非 为期 6 个月的激励体重维持计划（第三阶段）。参与者将被随机分配接受 每周减肥、饮食自我监控等辅助激励措施，或者两者兼而有之。我们将测量 6 岁（主要终点）、12 岁和 18 岁时达到临床显着体重减轻 ≥5% 的参与者比例 几个月。我们将评估外在动机和内在动机是否介导干预效果；计算 干预成本；并计算四个研究组的成本效益比。我们的财务激励措施 干预旨在通过使用现有技术和自动化流程来扩展 分析数据以近乎实时地提供激励。该干预措施可以与各种减肥相结合 由临床医生或付款人提供的干预措施，或整合到各种面向患者和消费者的干预措施中 技术。完成这项研究将有助于我们确定和实施的长期目标 有效、具有成本效益、可扩展的方法来减少肥胖和相关健康的患病率 结果。