Enhancing Emotion Regulation to Support Weight Control Efforts in Adolescents with Overweight and Obesity

加强情绪调节，支持超重和肥胖青少年的体重控制

• 批准号: 10264110
• 负责人: Wendy S Hadley
• 金额: $ 55.95万
• 依托单位: MIRIAM HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-16 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10264110
• 关键词: 15 year old; 17 year old; 19 year old; Address; Adolescence; Adolescent; Adolescent obesity; Adult; Age; Attention; Behavior; Behavior Control; Behavior Therapy; Behavioral Weight Control; Body Weight decreased; Body mass index; Chronic; Consumption; Data; Development; Dialectical behavior therapy; Diet; Eating; Emotional; Enrollment; Failure; Feeling; Food; Goals; Health; Hour; Intervention; Laboratories; Maintenance; Mental Health; Nutrient; Obesity; Outcome; Outpatients; Overweight; Participant; Pediatric Hospitals; Physical activity; Pilot Projects; Prevalence; Prevention; Process; Randomized; Randomized Controlled Trials; Reporting; Sampling; Site; Symptoms; Teenagers; Testing; Time; Treatment Efficacy; Weight; Weight maintenance regimen; Work; Youth; behavioral construct; control trial; diabetes control; dietary; distress tolerance; efficacious intervention; efficacy evaluation; emotion dysregulation; emotion regulation; emotional eating; executive function; food consumption; high body mass index; improved; innovation; intervention effect; meetings; mindfulness; moderate-to-vigorous physical activity; multi-site trial; negative affect; obesity in children; obesity treatment; peer; pilot trial; programs; rapid weight gain; response; sedentary; sedentary lifestyle; sex; skills; skills training

PROJECT SUMMARY/ABSTRACT The prevalence of adolescents struggling with excess weight is remarkably high, with 38.7% of 12-15 year-olds and 41.5% of 16-19 year-olds meeting criteria for overweight or obesity. While considerable attention has been given to comprehensive behavioral interventions to address obesity in children, there is less empirical evidence demonstrating efficacy of interventions with adolescents. Additionally, there is great variability in outcomes. Limited impact of adolescent weight control treatment may be attributable to the failure of these interventions to explicitly address key mechanisms that are necessary for successful weight loss. Notably, adolescents with poorer emotion regulation have been found to consume foods of lower diet quality and report greater time spent in sedentary behavior than their peers. Poor emotion regulation among adolescents has also been associated with more rapid weight gain and higher BMI. Data from adolescents with overweight/obesity from an outpatient weight management program at Hasbro Children's Hospital (N=124) indicate that 82% of these youth report emotion regulation scores that are comparable to youth with significant mental health problems; furthermore, there is a positive association between emotional dysregulation and BMI within this same treatment-seeking sample. Despite these established relationships, interventions targeting emotion regulation in adolescents with obesity are lacking. To fill this gap, our laboratory developed and piloted an adolescent weight control intervention (HealthTRAC) that combines two efficacious interventions, one targeting emotion regulation skill building, the other focused on behavioral weight control. Preliminary findings from the small pilot trial are promising and indicate that the developed HealthTRAC intervention is acceptable, feasible to deliver, and results in significant reduction in BMI (d=.58) and improvement in emotion regulation skills (d=.20-.35) relative to a standard behavioral weight control (SBWC) condition. The proposed multi-site trial builds on these previous findings and will evaluate the efficacy of the developed HealthTRAC intervention on improving emotion regulation skills and reducing adolescent BMI. We propose to enroll 200 adolescents (100 per site) between the ages of 13-17 years of age to receive either HealthTRAC or SBWC. Adolescents will be randomly assigned to treatment condition within site. Intervention components will be delivered in 27.5 hours of direct contact time across 12 months. All adolescents will be assessed prior to randomization (baseline), immediately following the intervention (4 months), upon completion of maintenance sessions (12 months) and 18 months after the start of intervention. The information gained in this project will extend our understanding of how improving emotion regulation abilities can enhance adolescent weight control interventions.

项目总结/摘要 与超重作斗争的青少年的比例非常高，12-15岁的青少年中有38.7% 41.5%的16-19岁青少年符合超重或肥胖标准。虽然受到了相当大的关注， 考虑到全面的行为干预来解决儿童肥胖问题， 证明对青少年干预的有效性。此外，结果也有很大的差异。 青少年体重控制治疗的有限影响可能归因于这些干预措施的失败， 明确解决成功减肥所必需的关键机制。值得注意的是， 情绪调节较差的人，吃的食物质量较低， 比同龄人更喜欢久坐。青少年的情绪调节能力差也是 与体重增加更快和BMI更高有关。超重/肥胖青少年的数据来自 Hasbro儿童医院的一项门诊体重管理计划（N=124）表明， 青少年报告的情绪调节分数与有严重心理健康问题的青少年相当; 此外，情绪失调与BMI之间存在正相关， 寻求治疗的样本。尽管有这些既定的关系，针对情绪调节的干预措施 肥胖的青少年缺乏。为了填补这一空白，我们的实验室开发并试用了一种青少年 体重控制干预（HealthTRAC），结合两种有效的干预措施，一种针对情绪 监管技能建设，另一个侧重于行为体重控制。小型飞行员的初步调查结果 试验是有希望的，并表明开发的HealthTRAC干预是可接受的，可行的交付， 并导致BMI显著降低（d=.58）和情绪调节技能改善（d=.20-.35） 相对于标准行为体重控制（SBWC）条件。拟议的多中心试验建立在这些基础上 之前的研究结果，并将评估开发的HealthTRAC干预措施对改善的功效 情绪调节技能和降低青少年BMI。我们计划入组200例青少年（每个研究中心100例） 年龄在13-17岁之间的人接受HealthTRAC或SBWC。青少年将随机 分配给研究中心内的治疗条件。干预组件将在27.5小时内直接交付 接触时间长达12个月。将在随机化前（基线）立即对所有青少年进行评估 干预后（4个月）、维持期结束后（12个月）和18个月 干预开始后。在这个项目中获得的信息将扩展我们对如何 提高情绪调节能力可以加强青少年体重控制干预。