Stepped Care for Weight Loss Maintenance

减肥保养的阶梯护理

基本信息

批准号：
10584935
负责人：
ARIANA MARIE CHAO
金额：
$ 38.86万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-05 至 2028-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10584935
关键词：
Accelerometer Address Adherence Behavior Behavior Control Behavior Therapy Body Weight Body Weight decreased Calories Caring Chronic Counseling Diet E-learning Eating Behavior Education Effectiveness of Interventions Electronic Mail Energy Intake Failure Feedback Frequencies Goals Healthcare Heterogeneity Individual Intake Intervention Life Style Maintenance Methods Modeling Monitor Nature Obesity Outcome Outcome Study Participant Patient Self-Report Patients Persons Phase Physical activity Professional counselor Provider Randomized Relapse Research Resources Schedule Telephone Text Text Messaging Time Visit Weight Weight maintenance regimen adult obesity behavioral adherence clinical practice clinically significant comorbidity cost digital health digital tool economic evaluation flexibility group intervention implementation cost improved incremental cost-effectiveness individual response lifestyle intervention novel obesity management obesity treatment patient oriented patient response primary outcome programs remote monitoring response success telemonitoring theories therapy design tool treatment as usual treatment response weight loss intervention weight maintenance wireless fidelity

项目摘要

PROJECT SUMMARY/ABSTRACT Weight loss maintenance remains the Achilles' heel of obesity management. Extended intervention contact reduces weight regain. However, continued counseling in practice is rare. Digital health interventions can address barriers to providing in-person maintenance counseling. Our long-term goal is to develop more effective weight loss maintenance strategies that are accessible, patient-centered, and tailored to meet individuals' needs. To accomplish this goal, the proposed trial will examine whether, after 16 weeks of initial weight loss, a stepped-care, digital health intervention improves the maintenance of a >5% weight loss. Phase I lifestyle phase, (UC); (STEP). SELF is a non-randomized, 16-week, weight-loss phase during which all participants wil receive the same group intervention designed to induce a > 5% weight l oss. In Phase II, a 52-week weight-loss maintenance 180 adults with obesity who have lost >5% will be randomized to one of three interventions: usual care daily self-monitoring of weight, diet, and physical activity with digital tools (SELF); or The UC group will receive monthly, emailed weight loss maintenance education. Participants in the group will have access to a digital health intervention that uses: l stepped care daily remote monitoring of weight, physical activity, and calorie intake; and automated, personalized text-messaging to adherence. 13 additionally (Step percentage weeks, transition encourage behaviora begin with access to the digital health program (Step 1). Participants who, after the first weeks, have not maintained their 5% weight loss or have regained 2 percentage points of their weight, will receive monthly visits with a counselor to promote behavioral adherence and address barriers 2). Participants who, at 26 weeks, have not maintained a > 5% weight loss or have regained 2 points with Step 2 will transition to twice-monthly counseling (Step 3). Participants who, at 39 still have not maintained a > 5% weight l oss or have regained 2 percentage points with Step 3 will to a partial meal replacement plan for the last 13 weeks (Step 4). l STEP will Our primary aim is to determine if SELF and STEP result in better maintenance of weight loss compared to UC. Our secondary aims are to examine differences in self-weighing frequency, eating behaviors, and physical activity, and examine if STEP, relative to SELF, produces greater improvements in weight, self-weighing frequency, eating behaviors, and physical activity. each We will also conduct an economic analysis to evaluate the incremental cost effectiveness of intervention per unit decrease in weight (kg).The expected outcome of the study is to demonstrate the efficacy of a digital health intervention for weight loss maintenance, providing a solution to many challenges that interfere with successful delivery of obesity treatment. We also expect to show the efficacy of a stepped care model for weight loss maintenance, providing a individuals' responses to treatment. strategy to address themarked heterogeneity in

项目摘要/摘要减肥维持仍然是阿喀琉斯肥胖管理的脚跟。扩展干预接触减轻体重恢复。但是，实践中继续咨询很少见。数字健康干预措施可以寻求提供面对面维护咨询的障碍。我们的长期目标是发展更多有效的减肥维持策略，可访问，以患者为中心且量身定制以满足个人的需求。为了实现这一目标，拟议的试验将检查初始16周后是否是否体重减轻，阶梯护理，数字健康干预措施可改善> 5％的体重减轻。阶段我生活方式阶段，（uc）; （步）。自己是一个非随机，16周的减肥阶段，在此期间所有参与者都将接受同一组旨在诱导> 5％体重的干预措施。在第二阶段，一个52周的减肥维护 180名肥胖成年人损失> 5％的成年人将被随机分为三种干预措施之一：通常的护理使用数字工具（自我）对体重，饮食和体育活动的每日自我监控；或者 UC组将每月通过电子邮件发送减肥维护教育。参与者小组将可以使用使用： l 阶梯护理每日远程监控体重，体育锻炼和卡路里摄入量；和自动化的个性化文本消息坚持。 13 此外（步百分比几周，过渡鼓励行为从访问数字健康计划开始（步骤1）。参与者，第一次之后几周，尚未保持其5％的体重减轻或恢复2个百分点的体重，将与辅导员每月访问以促进行为遵守并解决障碍 2）。 26周没有保持> 5％的体重减轻或恢复2的参与者2 步骤2的积分将过渡到每月两次咨询（第3步）。 39岁的参与者仍然没有保持> 5％的体重l oss或通过步骤3恢复了2个百分点在过去的13周内进行部分膳食替代计划（步骤4）。 l 步骤将我们的主要目的是确定是否与UC相比，自我和步骤可以更好地维持体重减轻。我们的次要目标是检查自我差异频率，饮食行为和体育锻炼的差异，并检查是否步骤相对于自我，体重的改善，自我投资的频率，饮食行为以及体育锻炼。每个我们还将进行经济分析，以评估每单位干预体重减轻（kg）。该研究的预期结果是证明数字健康干预措施减肥的功效，为许多挑战提供了解决方案这干扰了成功提供肥胖治疗。我们还希望显示出阶梯的功效减肥维持的护理模型，提供个人对治疗的反应。解决这些问题的策略在