Recruiting and Retaining Young Adults in Behavioral Weight Loss Treatment

描述（由申请人提供）： 这个指导以患者为导向的研究职业奖（K23）的目标是让Gokee-LaRose博士成为一名独立的研究者，专注于开发干预措施，以针对在过渡到年轻成年期期间可改变的CVD风险因素。该培训计划，通过教学和直接指导的培训经验，将使她能够发展以下方面的技能和专业知识：1）随机临床试验的设计和实施（重点是肥胖）; 2）定性研究方法，这将使她能够有效地为年轻人量身定制计划; 3）增加了对年轻人CVD危险因素的认识，以及RCT中用于评估新标志物的方法; 4）研究伦理和先进的统计技术需要分析数据从随机对照试验。米里亚姆医院/布朗医学院的资源以及与她的专家导师团队（Wing，Jelalian，Morrow，刘易斯和Fava博士）的密切联系将为她提供理想的环境，以实现她的培训和研究目标。18至25岁的年轻人体重增加和肥胖的风险特别高;然而，他们在标准计划中的代表性不足，并且对如何最好地招募和/或保留这一群体的治疗知之甚少。我们的试点数据表明，通过一个简短的，以诊所为基础的计划，可以实现显着的体重减轻，并在短期内保持。该提案的目标是双重的：1）进行旨在改善该年龄组招募和保留工作的形成性工作，2）进行随机临床试验，以测试三种不同方法的可行性和初步疗效，以长期控制体重。在第一阶段，80名18-25岁的超重或肥胖男性和女性将参加焦点小组，以解决招募，保留和治疗障碍。在第2阶段，90名参与者的新样本将入组一个简短的10周BWL项目，然后随机分配至三个维持组之一，持续12个月。联系时间表和交付格式将部分由第一阶段确定;三个武器将继续面对面，通讯控制，或继续接触的替代形式。将在基线、10周、6和12个月时进行评估。 公共卫生相关性：肥胖症在美国已经达到了流行病的比例，18至25岁的年轻人处于特别高的风险中;迄今为止，标准的行为减肥计划尚未成功地达到这一高风险群体。目前尚不清楚最初如何最好地招募这些人接受治疗，或如何长期留住他们接受治疗。这项研究填补了这一空白，因此具有重大的临床和公共卫生意义。

DESCRIPTION (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Award (K23) is to allow Dr. Gokee-LaRose to become an independent investigator focused on developing interventions to target modifiable CVD risk factors during the transition into young adulthood. This training plan, through didactic and direct mentored training experiences, will allow her to develop skills and expertise in: 1) design and conduct of randomized clinical trials (with an emphasis on obesity); 2) qualitative research methods, which will enable her to effectively tailor programs for young adults; 3) increased knowledge of CVD risk factors with relevance to young adults and methodology used to assess novel markers in RCTs; and 4) research ethics and the advanced statistical skills needed to analyze data resulting from RCTs. The resources at the Miriam Hospital/ Brown Medical School and close contact with her expert mentor team (Drs. Wing, Jelalian, Morrow, Lewis and Fava) will provide her with the ideal environment to achieve her training and research goals. Young adults between 18 and 25 are at particularly high risk for weight gain and obesity; yet, they are under-represented in standard programs and little is known about how best to recruit and/or retain this group in treatment. Our pilot data indicates significant weight losses can be achieved through a brief, clinic-based program with young adults, and maintained in the short-term. The goal of this proposal is twofold: 1) to conduct formative work aimed at improving recruitment and retention efforts with this age group, and 2) to conduct a randomized clinical trial to test the feasibility and preliminary efficacy of three different approaches to longer-term weight control. In Phase 1, 80 overweight or obese men and women ages 18-25 will participate in focus groups to address recruitment, retention and barriers to treatment. In Phase 2, a new sample of 90 participants will be enrolled in a brief, 10-week BWL program and then randomized to one of three maintenance arms through 12 months. Contact schedule and delivery format will be determined in part by Phase 1; the three arms will be continued face-to-face, a newsletter control, or an alternative form of continued contact. Assessments will take place at baseline, 10 weeks, 6 and 12 months. PUBLIC HEALTH RELEVANCE: Obesity has reached pandemic proportions in the United States, and young adults between 18 and 25 are at particularly high risk; yet to date, standard behavioral weight loss programs have not been successful at reaching this high-risk group. It remains unclear how best to recruit these individuals for treatment initially, or how to retain them in treatment in the longer-term. The proposed research fills this gap, and therefore stands to have substantial clinical and public health implications.