Food supplementation interventions to improve weight loss for adults with food insecurity and obesity

项目摘要/摘要 食物不安全在肥胖人群中很常见，与肥胖患者的次优结局有关。 行为减肥（BWL）治疗。然而，我们还没有证据表明治疗方法， 解决粮食不安全和肥胖问题，可以针对多个障碍，包括成本，获取，技能，知识， 和行为。 改善 该应用程序的首要目标是通过以下方式减少肥胖的社会经济差异 患者在BWL治疗期间负担和获得营养食物的能力。为了实现这一目标，拟议的3组平行设计随机对照试验将分配258名肥胖成人， 粮食不安全仅限于BWL（包括标准护理转诊和与社区粮食的联系 资源; 交付， 券 提供 的 n=86）; BWL加食物补充与任一食品券（BWL+VOUCHER; n=86）;家庭- 符合BWL建议的医疗定制杂货（BWL+HOME; n=86）。食品 并且在治疗的前24周提供HOME。所有组均接受BWL治疗 根据CMS指南，持续52周。将在基线和第12、24周（结束时）进行评估 食物补充）和52（BWL治疗结束）。 F 我们的目的是检验假设， BWL+VOUCHER和BWL+HOME在24周时的体重减轻（占初始体重的百分比）大于 BWL-单独。次要目的是确定BWL+VOUCHER和BWL+HOME是否能更好地减轻体重 与BWL单药相比，52周时。其他次要目的是检查治疗差异， 与健康相关的生活质量和自我报告的饮食质量客观指标。预期结果 这项研究的目的是证明可以在卫生保健系统中使用的可行的食品支持干预措施 解决健康问题的社会决定因素，实现更好的健康公平， 国家护理研究所的使命。

PROJECT SUMMARY/ABSTRACT Food insecurity is common among people with obesity and is associated with suboptimal outcomes in behavioral weight loss (BWL) treatment. However, we do not yet have evidence of treatment approach to address food insecurity and obesity that can target multiple barriers including cost, access, skills, knowledge, and behavior. improving The overarching goal of this application is to reduce socioeconomic disparities in obesity by patients' abilities to afford and access nutritious foods during BWL treatment. To accomplish thisgoal, the proposed 3-group, parallel design, randomized controlled trial will assign 258 adults with obesity and food insecurity to BWL-Alone (including standard-of-care referral and connection with community food resources; delivered, vouchers provided of n=86); BWL plus food supplementation with either food vouchers (BWL+VOUCHER; n=86); home- medically tailored groceries consistent with BWL recommendations (BWL+HOME; n=86). Food and HOME will be provided for the first 24 weeks o treatment. All groups will have BWL treatment for 52 weeks per CMS guidelines. Assessments will be conducted at baseline, and weeks 12, 24 (end food supplementation), and 52 (end of BWL treatment). f Our aims are to test the hypothesis that BWL+VOUCHER and BWL+HOME will result in greater weight loss (percent of initial weight) at 24 weeks than BWL-Alone. A secondary aim is to determine if BWL+VOUCHER and BWL+HOME result in better weight loss at 52 weeks compared to BWL-Alone. Additional secondary aims are to examine treatment differences in health-related quality of life and self-reported and objective measures of dietary quality. The expected outcome of this study is to demonstrate feasible food support interventions that can be used within health care systems to address social determinants of health and achieve better health equity, and is well aligned to contribute to the mission of the National Institute of Nursing Research.