Understanding Racial and Ethnic Differences in Weight Loss Maintenance and Regain

描述（由申请人提供）：减肥干预可以产生临床意义上的体重减轻，尽管大多数人在治疗后体重明显反弹。虽然影响长期减肥维持（WLM）的生物、行为和环境因素是复杂的，但很明显，促进长期减肥维持的行为和强化因素与最初减肥所需的行为和强化因素有很大不同。然而，我们目前缺乏一个明确的概念框架来整合和组织与WLM相关的行为、环境、社会和文化因素。此外，非裔美国人和白人的减肥治疗结果不同，非裔美国人最初的体重减轻较少，而白人的长期体重反弹较大。然而，造成这些治疗反应上的种族/民族差异的原因尚不清楚。因此，本项目的目标是提高我们对非裔美国人和白人之前实现临床有意义的体重减轻（即体重减轻5%）的WLM和体重恢复相关因素的理解。通过使用经过验证的新方法，包括名义群体技术（NGT）、卡片分类任务和认知映射，我们将研究与非裔美国人和白人中成功的WLM以及体重恢复相关的因素。通过从几个正在进行的减肥研究中招募，包括PI目前的一个WLM项目的K23随机对照试验，我们将有机会获得足够数量的以前成功减肥的个体。我们将特别针对四组参与者：1)非裔美国人减肥维持者，2)非裔美国人体重恢复者，3)白人减肥维持者，4)白人体重恢复者。通过NGT，非裔美国人和白人减肥者和恢复者将生成全面的、可能具有文化特异性的促进因素和阻碍减肥的因素清单（目标1）。然后，参与者将通过卡片分类任务对这些促进因素和障碍进行优先排序，并将其组织成有意义的类别，这将包括在聚类分析方法和认知映射中，以开发非裔美国人和白人的WLM概念框架（目标#2）。这项研究的发现将有助于我们了解对减肥和WLM治疗的反应差异，并指导未来文化量身定制的WLM干预措施的发展。

DESCRIPTION (provided by applicant): Weight loss interventions can produce clinically meaningful weight reductions, although most individuals experience significant weight regain following treatment. While the biological, behavioral, and environmental factors influencing long-term weight loss maintenance (WLM) are complex, it is clear that behaviors and reinforcers facilitating WLM differ greatly from those required for initial weight loss. However, we currently lack a well-specified conceptual framework that integrates and organizes behavioral, environmental, social, and cultural factors related to WLM. Additionally, weight loss treatment outcomes differ for African Americans and Whites, with African Americans losing less weight initially and Whites experiencing greater long-term weight regain. However, the reasons for these racial/ethnic differences in treatment response are unclear. Therefore, the goal of this project is to improve our understanding of factors associated with WLM and weight regain for African Americans and Whites who previously achieved clinically meaningful weight loss (i.e., >5% weight reduction). By utilizing validated methods novel to the investigation of WLM, including the nominal group technique (NGT), card-sorting tasks, and cognitive mapping, we will examine factors associated with successful WLM as well as weight regain among African Americans and Whites. By recruiting from several ongoing weight loss studies, including the PI's current K23 randomized controlled trial of a WLM program, we will have access to sufficient numbers of individuals who previously achieved weight loss. In particular, we will target four groups of participants: 1) African American weight loss maintainers, 2) African American weight regainers, 3) White weight loss maintainers, and 4) White weight regainers. Through the NGT, African American and White weight loss maintainers and regainers will generate comprehensive and potentially culturally-specific lists of facilitators and barriers to WLM (Aim #1). These facilitators and barriers will then be prioritized and organized into meaningful categories by participants through card-sorting tasks, which will be included in cluster analytic methods and cognitive mapping to develop conceptual frameworks of WLM for African Americans and Whites (Aim #2). Findings from this study will help us understand differences in response to weight loss and WLM treatments and guide the future development of culturally-tailored WLM interventions.