TREATMENT OF OBESITY IN UNDERSERVED RURAL SETTINGS-TOURS

服务水平低下的农村地区的肥胖症治疗 - 旅游

• 批准号: 6605966
• 负责人: MICHAEL G PERRI
• 金额: $ 71.1万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6605966
• 关键词: behavior therapy; behavioral /social science research tag; body physical activity; clinical research; clinical trials; disease /disorder prevention /control; female; health behavior; health disparity; health service demonstration project; health services research tag; human middle age (35-64); human old age (65+); human therapy evaluation; longitudinal human study; medically underserved population; obesity; patient oriented research; relapse /recurrence; rural area; telemedicine; weight loss

DESCRIPTION (provided by applicant): Higher rates of obesity, sedentary lifestyle, and coronary heart disease are observed in rural than non-rural areas of the U.S., yet the treatment of obesity in the rural population has received little research attention. Efficacy studies, typically conducted in urban settings, show that lifestyle interventions produce clinically significant weight reductions, but a regaining of lost weight commonly follows the conclusion of treatment. Recent studies have demonstrated that clinic-based, extended-care programs can improve the maintenance of lost weight. Thus, the next logical steps in this line of research are (a) to extend these studies to community settings with underserved populations and (b) to test alternative and potentially more efficient methods of providing extended care, such as through the use of telephone-based rather than clinic-based maintenance programs. The primary objective of TOURS is to test the effectiveness of weight-loss maintenance programs in a randomized controlled trial, conducted in medically underserved rural settings. Obese women (N=300), ages 50-75 years, from six medically underserved rural counties will be randomly assigned to one of three 18- months long obesity treatment programs. Each treatment condition will include an initial 6-month lifestyle intervention followed by one of three 12-month follow-up programs: (A) an Office-based Maintenance Program, (B) a Telephone-Based Maintenance Program, or (C) an Education Control Condition. Dependent variables to be assessed at baseline, 6 months, and 18 months will include body weight, as well as a selected Array of health-related indicators and quality of life measures. It is hypothesized that participants assigned to either of the experimental programs will exhibit better maintenance of lost weight compared with those assigned to the control condition. Potential mediators and moderators of the intervention program-weight change relationship will be examined, and exploratory analyses of the costs and cost effectiveness of the interventions will be conducted. This trial will contribute important public health information regarding methods for improving obesity management in an underserved population at high risk for weight-related chronic diseases and disability.

描述（由申请人提供）： 在美国，农村地区的肥胖率、久坐不动的生活方式和冠心病的发病率高于非农村地区，然而，农村人口肥胖症的治疗却很少受到研究关注。通常在城市环境中进行的功效研究表明，生活方式干预可产生临床显著的体重减轻，但通常在治疗结束后体重会恢复。最近的研究表明，以诊所为基础的扩展护理计划可以改善减肥的维持。因此，这一研究路线的下一个合乎逻辑的步骤是：（a）将这些研究扩展到服务不足的人群的社区环境;（B）测试提供长期护理的替代性和潜在的更有效方法，例如通过使用基于电话而不是基于诊所的维护程序。图尔斯的主要目的是在医疗服务不足的农村地区进行随机对照试验，以测试减肥维持计划的有效性。肥胖妇女（N=300），年龄50-75岁，来自六个医疗服务不足的农村县将被随机分配到三个18个月的肥胖治疗计划之一。每种治疗条件将包括最初6个月的生活方式干预，然后是三个12个月随访计划之一：（A）基于网络的维护计划，（B）基于电话的维护计划，或（C）教育控制条件。在基线、6个月和18个月时评估的因变量将包括体重以及选定的一系列健康相关指标和生活质量指标。据推测，分配到任何一个实验方案的参与者将表现出更好的维持减肥相比，那些分配到控制条件。将检查干预计划-体重变化关系的潜在中介者和调节者，并对干预措施的成本和成本效益进行探索性分析。这项试验将提供重要的公共卫生信息，关于改善服务不足人群中肥胖管理的方法，这些人群具有体重相关慢性疾病和残疾的高风险。

项目成果

Dietary self-monitoring and long-term success with weight management.

• DOI: 10.1002/oby.20807
• 发表时间: 2014-09
• 期刊: OBESITY
• 影响因子: 6.9
• 作者: Peterson, Ninoska D.;Middleton, Kathryn R.;Nackers, Lisa M.;Medina, Kristen E.;Milsom, Vanessa A.;Perri, Michael G.
• 通讯作者: Perri, Michael G.

The Association Between Rate of Initial Weight Loss and Long-Term Success in Obesity Treatment: Does Slow and Steady Win the Race?

• DOI: 10.1007/s12529-010-9092-y
• 发表时间: 2010-09-01
• 期刊: INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE
• 影响因子: 2.7
• 作者: Nackers, Lisa M.;Ross, Kathryn M.;Perri, Michael G.
• 通讯作者: Perri, Michael G.

Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial.

• DOI: 10.1001/archinte.168.21.2347
• 发表时间: 2008-11-24
• 期刊: ARCHIVES OF INTERNAL MEDICINE
• 作者: Perri, Michael G.;Limacher, Marian C.;Durning, Patricia E.;Janicke, David M.;Lutes, Lesley D.;Bobroff, Linda B.;Dale, Martha Sue;Daniels, Michael J.;Radcliff, Tiffany A.;Martin, A. Daniel
• 通讯作者: Martin, A. Daniel

The contributions of weight loss and increased physical fitness to improvements in health-related quality of life.

• DOI: 10.1016/j.eatbeh.2008.12.002
• 发表时间: 2009-04
• 期刊: EATING BEHAVIORS
• 影响因子: 2.8
• 作者: Ross, Kathryn M.;Milsom, Vanessa A.;Rickel, Katie A.;DeBraganza, Ninoska;Gibbons, Lauren M.;Murawski, Mary E.;Perri, Michael G.
• 通讯作者: Perri, Michael G.