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

食品补充剂干预措施可改善粮食不安全和肥胖成年人的减肥效果

• 批准号: 10708130
• 负责人: ARIANA MARIE CHAO
• 金额: $ 14.96万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-21 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10708130
• 关键词: Address; Adherence; Adult; Affect; American; Behavior; Behavioral; Biological Markers; Body Weight decreased; Carotenoids; Chronic; Communities; Data; Diabetes Mellitus; Diet Habits; Disparity; Disparity population; Education; Ensure; Food; Food Supplementation; Fruit; Goals; Guidelines; Health; Health Personnel; Health behavior; Healthcare; Healthcare Systems; Healthy Eating; Home; Improve Access; Individual; Intervention; Knowledge; Measures; Meat; Medical; Mission; National Institute of Nursing Research; Neighborhoods; Nutritional; Obesity; Obesity Epidemic; Outcome; Outcome Study; Participant; Patient Self-Report; Patients; Persons; Provider; Randomized, Controlled Trials; Recommendation; Research; Resources; Secure; Skin; Testing; Thinness; Time; Transportation; United States Centers for Medicare and Medicaid Services; Vegetables; Weight; Weight maintenance regimen; adult obesity; barrier to care; clinical care; cost; design; dietary; energy density; food desert; food environment; food insecurity; food resource; fruits and vegetables; good diet; health difference; health equity; health related quality of life; improved; indexing; novel; nutrition; obese patients; obesity treatment; patient screening; prevent; programs; skills; social; social disparities; social health determinants; socioeconomic disparity; socioeconomics; standard of care; treatment adherence; voucher; weight loss intervention

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.

项目概要/摘要 粮食不安全在肥胖人群中很常见，并且与肥胖结果不佳有关 行为减肥（BWL）治疗。然而，我们还没有治疗方法的证据 解决粮食不安全和肥胖问题，这些障碍可能涉及成本、获取途径、技能、知识、 和行为。 改善 该应用程序的总体目标是通过减少肥胖的社会经济差异 患者在 BWL 治疗期间购买和获取营养食物的能力。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 名患有肥胖症和 BWL-Alone 的粮食不安全问题（包括标准护理转诊和与社区粮食的联系） 资源; 发表， 优惠券 假如 的 n=86); BWL 加上使用任一食品券的食品补充剂（BWL+VOUCHER；n=86）；家- 符合 BWL 建议的医疗定制杂货（BWL+HOME；n=86）。食物 治疗的前 24 周将提供居家服务。所有组均接受 BWL 治疗 根据 CMS 指南，为期 52 周。评估将在基线以及第 12、24 周（结束时）进行 食物补充剂）和 52（BWL 治疗结束）。 f 我们的目标是检验以下假设： BWL+VOUCHER 和 BWL+HOME 在 24 周时的体重减轻（初始体重的百分比）比 BWL-独自一人。第二个目标是确定 BWL+VOUCHER 和 BWL+HOME 是否能带来更好的减肥效果 与 BWL-Alone 相比，在 52 周时。其他次要目标是检查治疗差异 与健康相关的生活质量以及饮食质量的自我报告和客观测量。预期结果 这项研究的目的是证明可在医疗保健系统内使用的可行的粮食支持干预措施 解决健康的社会决定因素并实现更好的健康公平，并致力于为 国家护理研究所的使命。