Enhancing Effectiveness of a Dissonance-Based Obesity Prevention Program

提高基于失调的肥胖预防计划的有效性

• 批准号: 10102523
• 负责人: ERIC M STICE
• 金额: $ 40.82万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-11-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10102523
• 关键词: Enhancing; Effectiveness; Dissonance; Based; Obesity

ABSTRACT Prevention is key for combating obesity, but few programs have prevented future increases in BMI and onset of overweight/obesity, particularly during late adolescence when youth often assume responsibility for dietary intake and exercise choices. One exception is a brief 6-hr dissonance-based program (Project Health) wherein participants make small lasting incremental lifestyle changes to dietary intake and exercise to reach energy balance, and discuss costs of obesity, an unhealthy diet, and sedentary behavior, and benefits of leanness, a healthy diet, and exercise, which prompts them to align their attitudes with their publically displayed behavior. These activities promote internalization of health goals and executive control over lifestyle behaviors. Late adolescents randomized to Project Health showed less increases in BMI and a 41% and 43% reduction in overweight/obesity onset over 2-yr follow-up compared to a version of the program lacking dissonance- induction activities and an obesity education condition. Project Health appears to be the first program to produce these key obesity prevention effects relative to an alternative intervention, but it is critical to increase effects. A dissonance-based prevention program was more effective when implemented in single- versus mixed-sex groups, theoretically because it promoted greater participation in dissonance-inducing discussions. Aim 1a is to test whether the weight gain prevention effects will be larger when Project Health is implemented in single-sex groups; we will randomize 450 17-20 year olds to complete Project Health in female, male, or mixed-sex groups, assessing outcomes at pretest, posttest, and 6, 12, 24, and 36-month follow-ups. Aim 1b is to test whether greater participation in dissonance-inducing discussions and group cohesion mediate the effect of condition on any superior weight gain prevention effects. Adolescents who show greater fMRI-assessed reward and attention region responsivity to food images exhibit elevated future weight gain, implying that reducing this responsivity may reduce future weight gain. In a pilot trial, late adolescents who completed go/no- go, stop-signal, and respond-signal computer training in which they repeatedly inhibit responses to high-calorie foods and respond to low-calorie foods, and dot-probe and visual-search computer tasks that train attention away from high-calorie foods and to low-calorie foods, showed a greater reduction in reward and attention region responsivity to, palatability rating of, and willingness to pay for, high-calorie foods, suggesting reduced valuation and attentional bias, as well as greater fat loss over 1-yr follow-up versus controls who completed the training with non-food images. Aim 2a is to test whether adding food response and attention training to Project Health will produce larger weight gain prevention effects. Participants in the 3 conditions will be randomized to complete response and attention training for 25-mins after each of the 6-sessions with either food or non-food images. Aim 2b is to test whether reduced palatability ratings of, willingness to pay, and attentional bias for high-calorie foods mediate the effect of training condition on any superior weight gain prevention effects.

摘要 预防是对抗肥胖的关键，但很少有项目能阻止未来BMI和发病率的增加。 超重/肥胖，特别是在青春期后期，年轻人往往承担饮食责任， 摄入量和锻炼选择。一个例外是一个简短的6小时不和谐为基础的计划（项目健康），其中 参与者通过饮食摄入和锻炼来获得能量， 平衡，并讨论肥胖的成本，不健康的饮食，久坐不动的行为，以及瘦的好处， 健康的饮食和锻炼，这促使他们将自己的态度与他们的行为表现相一致。 这些活动促进健康目标的内化和对生活方式行为的执行控制。晚 随机分配到健康项目的青少年显示BMI增加较少， 超重/肥胖的发生超过2年的随访相比，一个版本的程序缺乏不和谐- 诱导活动和肥胖教育条件。健康计划似乎是第一个 相对于替代干预措施，产生这些关键的肥胖预防效果，但关键是增加 方面的影响.基于不和谐的预防计划在单独实施时比在单独实施时更有效。 从理论上讲，这是因为它促进了更多人参与引起不和谐的讨论。 目的1a是测试在实施健康项目后，体重增加预防效果是否会更大 我们将随机抽取450名17-20奥尔兹的青少年，按女性、男性或 混合性别组，评估测试前、测试后以及6个月、12个月、24个月和36个月随访的结果。目标1b是 测试更多地参与诱发不和谐的讨论和群体凝聚力是否会介导这种效果 任何优越的上级体重增加预防效果的条件。表现出更高fMRI评估的青少年 奖励和注意区域对食物图像的反应表现出未来体重增加，这意味着， 降低这种响应度可能会减少未来的体重增加。在一项试点试验中，完成go/no- 进行、停止信号和响应信号计算机训练，其中它们反复抑制对高热量的反应 食物和对低热量食物的反应，以及训练注意力的点探测和视觉搜索计算机任务 远离高热量食物和低热量食物的人， 区域对高热量食物的反应、适口性评级和支付意愿，表明 评估和注意力偏差，以及1年随访期间与完成 用非食物图像训练。目标2a是测试是否在项目中增加食物反应和注意力训练 健康会产生较大的预防体重增加的效果。3种情况下的受试者将被随机分配至 在6次食物或非食物训练后，完成25分钟的反应和注意力训练 图像.目标2b是测试是否降低适口性评级，支付意愿，和注意力偏差， 高热量食物调节训练条件对任何优越的上级体重增加预防效果的影响。