Community Based Obesity Prevention Among Black Women

描述（由申请人提供）：黑人妇女的肥胖预防是一个主要的公共卫生优先事项;目前，近54%的成年黑人女性人口肥胖。迄今为止，大多数干预措施都集中在减轻超重和肥胖者的体重上。然而，这两种情况都是众所周知的难以治疗的，特别是在黑人中。我们认为，肥胖预防可能是一个特别有效的干预策略，超重的黑人妇女。大多数研究表明，与白人相比，黑人女性对超重的社会接受度更高，对体重的不满更少，理想体重更高。此外，许多研究表明，与白色妇女相比，黑人妇女的肥胖致死率较低，并发症较少，这表明保持超重可能是黑人妇女适当的公共卫生目标。我们认为，一种强调保持超重，同时防止向肥胖过渡的干预方法将在目标人群中产生共鸣。很少有肥胖预防RCT出现在已发表的文献中，据我们所知，没有一项仅在黑人妇女中进行。我们建议将超重的黑人女性（n=184）随机分为常规护理（UC）或肥胖预防（OP）干预条件。OP条件由几个干预组件组成，将在12个月内交付;每个参与者将收到量身定制的行动计划，量身定制的印刷材料，每月的辅导电话，并通过交互式语音应答系统每周进行自我监测。将在基线、基线后12个月和18个月进行评估。主要结局是18个月时BMI的变化。次要结果包括18个月的肥胖风险行为变化、身体成分测量、心理社会介质和肥胖相关生物标志物。我们在随机分配至OP条件的患者中设定了BMI维持目标。公共卫生相关性：目前，近54%的黑人妇女肥胖，但现有的减肥干预措施对这一人群并不十分成功。我们认为，在健康的超重女性中预防肥胖可能有助于预防肥胖及其相关的健康后果。我们建议在初级保健环境中进行干预，采用创新方法预防中年黑人妇女肥胖。

DESCRIPTION (provided by applicant): Obesity prevention among Black women is a major public health priority; presently, nearly 54% of the adult Black female population is obese. To date, most intervention attention has been focused on weight reduction among the overweight and obese. However, both conditions are notoriously recalcitrant to treatment, particularly among Blacks. We posit that obesity prevention might represent a particularly effective intervention strategy for overweight Black women. Most studies have shown that Black women have a greater social acceptance of overweight, less body weight dissatisfaction, and higher ideal body weights, compared to Whites. Furthermore, numerous studies have shown that obesity is less lethal and causes fewer co-morbidities among Black vs. White women, suggesting that maintaining overweight may be an appropriate public health goal for Black women. We posit that an intervention approach that emphasizes maintaining overweight, while preventing the transition to obesity will resonate among the target population. Very few obesity prevention RCTs appear in the published literature and, to our knowledge, none have been conducted solely among Black women. We propose to randomize overweight, Black women (n=184) to either usual care (UC) or an obesity prevention (OP) intervention condition. The OP condition is comprised of several intervention components that will be delivered over 12 months; each participant will receive a tailored action plan, tailored print materials, monthly coaching calls, and weekly self-monitoring via an interactive voice response system. Assessments will be taken at baseline, 12, and 18-months post baseline. The primary outcome is change in BMI at 18-months. Secondary outcomes include 18-month change in obesity risk behaviors, measures of body composition, psychosocial mediators, and obesity related biomarkers. We have set a target of BMI maintenance among those randomized to the OP condition. PUBLIC HEALTH RELEVANCE: At present, nearly 54% of Black women are obese, but existing weight loss interventions are not very successful for this population. We think that preventing obesity among healthy overweight women might help to prevent obesity and its associated health consequences. We propose to conduct an intervention in the primary care setting that uses an innovative approach to prevent obesity among Black women in middle age.