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坚持时，基于证据的体重管理计划是有效的 建议。然而，很大一部分寻求治疗的人没有临床经验 体重明显减轻。需要创新策略来优化体重管理的行为改变 干预措施。拟议的随机对照试验测试了两种自我监管方法来改善 超重或肥胖个体的有意减肥和饮食质量：（1）环境控制 策略（避免）和（2）冲动控制训练策略（抵抗）。具体来说，500 名女性和男性（BMI 25-39.9 kg/m2 之间）将从 Cedars-Sinai 医疗中心的医院和诊所网络中招募。 所有参与者都将参加为期 12 个月的体重管理计划（WW，前身为慧俪轻体©） 重点关注饮食、身体活动和思维技能，并随机分配到四个研究组之一：(1) 仅 WW，(2) WW + 改变家庭食品环境和在线杂货配送（避免），（3）WW + 游戏化抑制 控制训练（RESIST），（4）WW + AVOID + RESIST。基线、6 个月和 12 个月评估将 由经验丰富、会讲英语和西班牙语的研究人员完成。目标 1（结果）。 (a) 测试如何避免 RESIST 影响体重减轻和腰围（主要）和饮食质量（次要）。 H1a：避免 和/或 RESIST（第 2、3、4 组）与 6 个月和 12 个月时间点相比，将导致更大的体重减轻 独自一人。 (b) 测试“避免”和“抵制”对现有家庭成员饮食质量的潜在连锁反应 （主要）和重量（次要）。 H1b：我们预测避免（第 2 组和第 4 组）将产生更大的饮食 家庭成员的变化比单独的 WW 和 RESIST 的变化要大（第 1 组和第 3 组）。目标 2（机制）。测试 通过（a）比较抑制控制和抵抗的纵向变化来了解避免和抵抗的机制途径 各研究组的家庭食品环境； (b) 抑制控制是否与家庭食物环境有关 调解研究组与人体测量和饮食结果之间的关系。 H2：避免将 导致家庭食物环境发生变化，RESIST 将进行抑制控制。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 成分、体力活动、基线 BMI 和执行功能），以及 (b) 过程数据（频率 杂货配送、外出就餐和外卖、冲动控制训练和 WW 应用程序使用）调节关系 研究组与人体测量和饮食结果之间的关系。这些考虑因素很重要，可以帮助 解释干预结果的异质性，并了解谁从避免和/或抵制中受益。