Is long-term maintenance worth the wait? Using real time data capture to examine delayed discounting as a putative target of physical activity adherence in weight loss maintenance interventions

减肥维持(WLM)是体重管理中的主要挑战。而大多数个人谁 减肥想要保持体重，遵循行为建议的衰败是很常见的， 导致体重回升。WLM行为干预可以帮助维持健康的生活方式，但应对 治疗方法是不同的。此外，干预措施发挥作用的行动机制并不是 明确阐明，这阻碍了更有效的治疗方法的发展。晋级 行为改变的科学，需要研究来确定WLM从事的假定目标 以及推动行为改变的干预措施。时间自我调节理论(TST)假设 意图导致的行为在很大程度上取决于自我调节能力(即执行功能)。 与WLM特别相关的是延迟折扣(DD)的认知结构，即折扣倾向 较大的未来奖励(体重管理)，有利于较小的即时奖励(例如，令人愉快的 久坐活动)。实验和临床研究表明，DD在行为决策中起着重要作用。 制定和预测健康行为变化，但尚未在世界卫生运动的背景下进行探索。此外， TST假定了环境的调节作用，使得当从事一种行为的成本(例如， 在恶劣天气下锻炼)比它的好处(改善健康)更接近，自我调节 像DD这样的结构将成为行为的更强决定因素。这项拟议研究的目的是测试 是否如TST预测的那样，延迟打折会影响坚持体力活动(PA) WLM干预措施中的建议以及环境因素是否缓和了这种关系。爸爸是 注意力集中的行为是WLM成功的一个强有力的预测因子，并且可以在自然的 环境。这项工作是新颖的，因为它将使用实验医学方法来确定 DD被行为的WLM干预所吸引，该干预通过使用情节未来明确地针对DD 思考是一种可视化的程序，它展示了放大长期回报价值的希望，因此 减少DD。DD投入和体力活动之间的时间关联将通过 实时数据捕获方法(生态瞬时评估和加速度计)提供细微差别 了解假定目标(DD)如何/何时参与WLM治疗，以及这是否 敬业度预示着PA行为的持续变化。这种密集的人内纵向设计还将 允许探索环境因素如何缓和延迟折扣-体力活动链接， 为未来针对减肥维持的适时适应性干预做好准备。

Weight loss maintenance (WLM) is the major challenge in weight management. While most individuals who lose weight intend to keep their weight off, decay in adherence to behavioral recommendations is common, leading to weight regain. Behavioral WLM interventions can help sustain healthy lifestyles but response to treatment is variable. Moreover, the mechanisms of action by which interventions exert their effects are not clearly elucidated, which has thwarted the development of more efficacious treatment approaches. To advance the science of behavior change, research is needed to identify putative targets that are engaged by WLM interventions and that drive behavior change. Temporal Self-Regulation Theory (TST) posits that whether intentions lead to behavior depends, in large part, on self-regulatory capacity (i.e., executive function). Particularly relevant to WLM is the cognitive construct of delayed discounting (DD), or the tendency to discount a larger future reward (weight management) in favor of smaller immediate rewards (e.g., a pleasurable sedentary activity). Experimental and clinical research suggests that DD is instrumental in behavioral decision- making and predictive of health behavior change but has yet to be explored in the context of WLM. Further, TST posits a moderating role for the environment such that when the costs of engaging in a behavior (e.g., exercising in bad weather) are more proximal than its benefits (health improvements), self-regulatory constructs such as DD will be a stronger determinant of behavior. The aim of the proposed study is to test whether, as predicted by TST, delayed discounting mediates adherence to physical activity (PA) recommendations in WLM interventions and whether environmental factors moderate this relationship. PA is the behavior of focus as it is a robust predictor of WLM success and can be measured objectively in the natural environment. This work is novel because it will use an experimental medicine approach to establish whether DD is engaged by a behavioral WLM intervention that explicitly targets DD through the use of episodic future thinking, a visualization procedure that shows promise in amplifying the value of long-term rewards, thus reducing DD. Temporal associations between engagement of DD and physical activity will be examined with real time data capture methods (Ecological Momentary Assessment and accelerometry) providing a nuanced understanding of how/when the putative target (DD) is in engaged in WLM treatment and whether this engagement predicts sustained PA behavior change. This intensive within-person longitudinal design will also allow for an exploration of how environmental factors moderate the delayed discounting-physical activity link, setting the stage for a future just-in-time adaptive intervention for weight loss maintenance.