Enhancing Emotion Regulation to Support Weight Control Efforts in Adolescents with Overweight and Obesity

加强情绪调节，支持超重和肥胖青少年的体重控制

• 批准号: 10438857
• 负责人: Wendy S Hadley
• 金额: $ 58.96万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-16 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10438857
• 关键词: 15 year old; 17 year old; 19 year old; Address; Adolescence; Adolescent; Adolescent obesity; Adult; Age; Attention; Behavior; Behavior Control; Behavior Therapy; Behavioral Weight Control; Body Weight decreased; Body mass index; Chronic; Consumption; Data; Development; Dialectical behavior therapy; Diet; Eating; Emotional; Enrollment; Failure; Feeling; Food; Goals; Health; Hour; Intervention; Laboratories; Maintenance; Mental Health; Nutrient; Obesity; Outcome; Outpatients; Overweight; Participant; Pediatric Hospitals; Physical activity; Pilot Projects; Prevalence; Prevention; Process; Randomized; Randomized Controlled Trials; Reporting; Sampling; Site; Symptoms; Teenagers; Testing; Time; Treatment Efficacy; Weight; Weight maintenance regimen; Work; Youth; behavioral construct; control trial; diabetes control; dietary; distress tolerance; efficacious intervention; efficacy evaluation; emotion dysregulation; emotion regulation; emotional eating; executive function; food consumption; high body mass index; improved; innovation; intervention effect; meetings; mindfulness; moderate-to-vigorous physical activity; multi-site trial; negative affect; obesity in children; obesity treatment; peer; pilot trial; programs; rapid weight gain; response; sedentary; sedentary lifestyle; sex; skills; skills training

PROJECT SUMMARY/ABSTRACT The prevalence of adolescents struggling with excess weight is remarkably high, with 38.7% of 12-15 year-olds and 41.5% of 16-19 year-olds meeting criteria for overweight or obesity. While considerable attention has been given to comprehensive behavioral interventions to address obesity in children, there is less empirical evidence demonstrating efficacy of interventions with adolescents. Additionally, there is great variability in outcomes. Limited impact of adolescent weight control treatment may be attributable to the failure of these interventions to explicitly address key mechanisms that are necessary for successful weight loss. Notably, adolescents with poorer emotion regulation have been found to consume foods of lower diet quality and report greater time spent in sedentary behavior than their peers. Poor emotion regulation among adolescents has also been associated with more rapid weight gain and higher BMI. Data from adolescents with overweight/obesity from an outpatient weight management program at Hasbro Children's Hospital (N=124) indicate that 82% of these youth report emotion regulation scores that are comparable to youth with significant mental health problems; furthermore, there is a positive association between emotional dysregulation and BMI within this same treatment-seeking sample. Despite these established relationships, interventions targeting emotion regulation in adolescents with obesity are lacking. To fill this gap, our laboratory developed and piloted an adolescent weight control intervention (HealthTRAC) that combines two efficacious interventions, one targeting emotion regulation skill building, the other focused on behavioral weight control. Preliminary findings from the small pilot trial are promising and indicate that the developed HealthTRAC intervention is acceptable, feasible to deliver, and results in significant reduction in BMI (d=.58) and improvement in emotion regulation skills (d=.20-.35) relative to a standard behavioral weight control (SBWC) condition. The proposed multi-site trial builds on these previous findings and will evaluate the efficacy of the developed HealthTRAC intervention on improving emotion regulation skills and reducing adolescent BMI. We propose to enroll 200 adolescents (100 per site) between the ages of 13-17 years of age to receive either HealthTRAC or SBWC. Adolescents will be randomly assigned to treatment condition within site. Intervention components will be delivered in 27.5 hours of direct contact time across 12 months. All adolescents will be assessed prior to randomization (baseline), immediately following the intervention (4 months), upon completion of maintenance sessions (12 months) and 18 months after the start of intervention. The information gained in this project will extend our understanding of how improving emotion regulation abilities can enhance adolescent weight control interventions.

项目概要/摘要 青少年体重过重的比例非常高，12-15 岁青少年中这一比例为 38.7% 16-19 岁人群中有 41.5% 符合超重或肥胖标准。虽然受到了相当大的关注 对于解决儿童肥胖问题的综合行为干预措施，经验证据较少 证明对青少年的干预措施的有效性。此外，结果存在很大差异。 青少年体重控制治疗的影响有限可能是由于这些干预措施未能 明确阐述成功减肥所需的关键机制。值得注意的是，青少年患有 研究发现，情绪调节能力较差会消耗饮食质量较低的食物并报告较长的时间 与同龄人相比，他们在久坐行为上花费的时间更多。青少年的情绪调节能力也较差 与体重增加更快和体重指数更高有关。来自超重/肥胖青少年的数据 孩之宝儿童医院 (Hasbro Children's Hospital) 的一项门诊体重管理计划 (N=124) 表明，其中 82% 青少年报告的情绪调节得分与有严重心理健康问题的青少年相当； 此外，情绪失调与体重指数（BMI）之间存在正相关关系。 寻求治疗的样本。尽管存在这些已建立的关系，但针对情绪调节的干预措施 肥胖青少年缺乏。为了填补这一空白，我们的实验室开发并试点了一种青少年 体重控制干预 (HealthTRAC) 结合了两种有效的干预措施，其中一种针对情绪 调节技能培养，另一个重点是行为体重控制。小型试点的初步调查结果 试验是有希望的，并表明开发的 HealthTRAC 干预措施是可以接受的、可行的， 并导致体重指数显着降低 (d=.58) 和情绪调节技能提高 (d=.20-.35) 相对于标准行为体重控制（SBWC）条件。拟议的多站点试验建立在这些基础上 之前的发现，并将评估已开发的 HealthTRAC 干预措施在改善 情绪调节技能和降低青少年体重指数。我们建议招收 200 名青少年（每个地点 100 名） 年龄在 13-17 岁之间即可接受 HealthTRAC 或 SBWC。青少年将随机 分配给现场内的治疗条件。干预组件将在 27.5 小时内直接交付 接触时间跨越12个月。所有青少年将在随机分组（基线）之前立即接受评估 干预后（4 个月）、维护课程完成后（12 个月）和 18 个月 干预开始后。在这个项目中获得的信息将加深我们对如何 提高情绪调节能力可以加强青少年体重控制干预。