Evaluating environmental control (AVOID) and inhibitory control (RESIST) strategies to improve weight management outcomes

评估环境控制 (AVOID) 和抑制控制 (RESIST) 策略以改善体重管理结果

• 批准号: 10570212
• 负责人: Sarah-Jeanne Salvy
• 金额: $ 71.58万
• 依托单位: CEDARS-SINAI MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-15 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10570212
• 关键词: Address; Adherence; Affect; Age; Alcohol consumption; Asthma; Behavioral; Biometry; Body Weight decreased; Body mass index; Cardiovascular Diseases; Characteristics; Clinics and Hospitals; Cues; Data; Development; Diet; Dyslipidemias; Eating Behavior; Effectiveness; Enrollment; Environment; Ethnic Origin; Fatigue; Food; Fostering; Frequencies; Genetic; Health; Heterogeneity; Home; Home environment; Household; Individual; Informal Social Control; Intervention; Life Style; Malignant Neoplasms; Mediating; Medical center; Modification; Muscle; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Obstructive Sleep Apnea; Outcome; Overweight; Participant; Pathway interactions; Persons; Physical activity; Process; Public Health; Randomized; Randomized, Controlled Trials; Recommendation; Research; Self-control as a personality trait; Site; Smoking; Socioeconomic Status; Testing; Training; United States; Weight; Weight maintenance regimen; Woman; Work; arm; behavior change; clinically significant; cognitive testing; cognitive training; cost; demographics; dietary; evidence base; executive function; experience; food environment; four-arm study; improved; innovation; member; men; obesity risk; obesity treatment; programs; prospective; recruit; sex; skills; waist circumference; weight loss program

ABSTRACT Evidence-based weight management programs are effective when individuals are able to consistently adhere to recommendations. However, a large proportion of treatment-seeking individuals do not experience clinically significant weight loss. Innovative strategies are needed to optimize behavior change in weight management interventions. The proposed randomized controlled trial tests two self-regulatory approaches to improve intentional weight loss and diet quality in individuals with overweight or obesity: (1) an environmental control strategy (AVOID) and (2) an impulse control training strategy (RESIST). Specifically, 500 women and men (BMI between 25-39.9 kg/m2) will be recruited from the Cedars-Sinai Medical Center network of hospitals and clinics. All participants will be enrolled in a 12-month weight-management program (WW, formerly Weight Watchers©) focusing on diet, physical activity and mindset skills, and randomized to one of four study arms: (1) WW only, (2) WW + modification of home food environment and online grocery delivery (AVOID), (3) WW + gamified inhibitory control training (RESIST), (4) WW + AVOID + RESIST. Baseline, 6- and 12-month assessments will be completed by experienced, English and Spanish speaking study staff. Aim 1 (Outcomes). (a) Tests how AVOID and RESIST affect weight loss and waist circumference (primary) and diet quality (secondary). H1a: AVOID and/or RESIST (arms 2, 3, 4) will result in greater weight loss at 6-month and 12-month timepoints compared to WW alone. (b) Tests potential ripple effects of AVOID and RESIST on available household members' diet quality (primary) and weight (secondary). H1b: We predict that AVOID (arms 2 and 4) will produce greater dietary changes in household members than WW alone and RESIST (arms 1 and 3). Aim 2 (Mechanisms). Tests the mechanistic pathways of AVOID and RESIST by (a) comparing longitudinal changes in inhibitory control and home food environment across study arms; and (b) whether inhibitory control and the home food environment mediate the relationships between study arms and anthropometric and dietary outcomes. H2: AVOID will produce changes in the home food environment and RESIST will operate on inhibitory control. Aim 3 (Moderators). Examines how (a) individual characteristics (age, sex, ethnicity, socioeconomic status, household composition, physical activity, baseline BMI and executive functioning), and (b) process data (frequency of grocery delivery, dining out and take out, impulse control training and WW app use) moderate the relationship between study arms and anthropometric and dietary outcomes. These considerations are important to help explain heterogeneity in intervention outcomes and to understand who benefits from AVOID and/or RESIST.

抽象的 当个人能够始终如一地遵守时，基于证据的体重管理计划是有效的 建议。但是，很大一部分寻求治疗的人在临床上没有经历 重大减肥。需要创新策略来优化体重管理的行为变化 干预措施。提出的随机对照试验测试两种自我调节方法以改进 超重或肥胖的人的故意减肥和饮食质量：（1）环境控制 策略（避免）和（2）冲动控制训练策略（抵抗）。具体而言，有500名男性和男性（BMI） 在25-39.9 kg/m2之间）将从雪松西奈医学中心的医院和诊所网络中招募。 所有参与者将参加为期12个月的体重管理计划（WW，以前是体重观察者©） 专注于饮食，体育锻炼和心态技能，并随机分配到四个研究臂之一：（1）仅WW，（2） WW +修改家庭食品环境和在线杂货店的交付（避免），（3）WW + GAMIIFIED抑制性 控制训练（抵抗），（4）WW +避免 +抵抗。基线，6个月和12个月的评估将是 由经验丰富的英语和西班牙语学习人员完成。目标1（结果）。 （a）测试如何避免 并抵抗减肥和腰部循环（初级）和饮食质量（次要）。 H1a：避免 和/或抵抗（武器2、3、4）将在6个月和12个月的时间点下增加体重减轻 独自一人。 （b）测试避免和抵抗可用家庭成员饮食质量的潜在连锁反应的影响 （初级）和体重（次要）。 H1B：我们预测避免（武器2和4）会产生更大的饮食 家庭成员的变化比单独使用并抵抗（武器1和3）。目标2（机制）。测试 通过（a）比较抑制性控制和 整个研究臂的家庭食品环境； （b）抑制控制和家庭食品环境是否 调解研究臂与人体测量和饮食结果之间的关系。 H2：避免意志 在家庭食物环境中产生变化，抗拒将在抑制性控制下运作。目标3 （主持人）。检查（a）个人特征（年龄，性别，种族，社会经济地位，家庭）如何 组成，体育锻炼，基线BMI和执行功能）和（b）过程数据（频率 杂货店交货，外出就餐和外出，冲动控制培训和WW应用程序使用）调节关系 研究臂与人体测量和饮食结果之间。这些考虑对于帮助很重要 解释干预结果中的异质性，并了解谁从避免和/或抵抗中受益。