A Randomized Trial Testing Lay Health Coaches for Obesity Treatment

一项针对肥胖治疗的非专业健康教练的随机试验测试

• 批准号: 8865609
• 负责人: Tricia M Leahey
• 金额: $ 30.26万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8865609
• 关键词: Accountability; Area; Behavior; Behavioral; Body Weight decreased; Caring; Data; Diabetes Mellitus; Electronic Mail; Feedback; Frustration; Glycosylated hemoglobin A; Health; Health Care Visit; Health behavior; Health behavior change; Individual; Lateral; Mediating; Mentors; Motivation; Outcome; Participant; Patients; Performance; Pilot Projects; Play; Preparation; Process; Protocols documentation; Public Health; Randomized; Reporting; Role; Schedule; Social support; Testing; Time; Treatment outcome; Weight; Weight maintenance regimen; Weights and Measures; arm; behavior change; clinically significant; diabetes management; improved; innovation; meetings; novel; obesity treatment; peer; programs; randomized trial; social; standard care; theories; treatment program; weight loss intervention

DESCRIPTION (provided by applicant): Lay health coaches provide support and accountability between health care visits to promote behavior change. There are 2 types of lay coaches, Peers (2 individuals initiating behavior change coach one another) and Mentors (individuals who previously and successfully modified their behavior coach patients just starting to change their behavior). Lay coaches have not been tested for obesity treatment. The only trials with objective outcomes are in the area of diabetes management, and results suggest that Peers may be more effective than Mentors. Similarly, findings from Social Comparison Theory show that lateral comparisons with "similar" targets (e.g., Peers) may promote greater motivation and health behavior change than upward comparisons with "more successful" targets (e.g., Mentors), as comparisons with successful targets can induce frustration and hinder performance. Although a natural fit, Social Comparison Theory has not been used to understand the effects of Peer and Mentor Health Coaches on health outcomes. Moreover, the2types of lay coaches have not been directly compared in any area. We conducted a 6-month pilot study testing Peer and Mentor Health Coaches for weight loss. Participants received a group behavioral weight loss program (BWL) and were randomized to a Peer or Mentor Health Coach. BWL treatment involved a reduced contact schedule; sessions were weekly for 6-weeks, biweekly for 6-weeks, and monthly thereafter. On weeks that group did not meet, participants emailed their week's weight, calorie, and activity information to their coach and received feedback. Results were impressive. Compliance with the coaching protocol was excellent. The Peer condition yielded superior weight loss outcomes compared to the Mentor condition (-8.7kg v. -5.3kg). Moreover, Peer participants engaged in lateral comparisons with their coach whereas Mentor participants engaged in upward comparisons, and lateral comparisons were associated with greater weight loss outcomes. These preliminary findings provide strong evidence that 1) lay health coaches are feasible for obesity treatment, 2) Peer Health Coaches may yield particularly impressive weight losses, and 3) social comparison processes may play an important role in Peer and Mentor Health Coach Treatment outcomes. We propose to test lay health coaches for obesity treatment. Participants will be randomized to BWL+Peer, BWL+Mentor, or BWL alone. BWL will involve a reduced contact schedule; sessions will be weekly for 6-weeks, biweekly for 6-weeks, and monthly for the remaining 9-months. During weeks that group does not meet, Peer and Mentor participants will email their progress to their coach and receive feedback. We hypothesize that BWL+Peer Coach will yield superior weight losses at 12-months compared to BWL+Mentor and BWL alone and that Peer and Mentor arms will differ on social comparison direction. If these hypotheses are supported, we will explore whether social comparison direction mediates 12-month weight loss outcomes between the Peer and Mentor study arms. This project tests a novel, theoretically-grounded, disseminable approach to obesity treatment. If successful, this approach could substantially inform current obesity treatment efforts.

描述(由申请者提供)：业馀健康教练在健康护理访问之间提供支持和责任，以促进行为改变。有两种类型的业馀教练，同龄人(两个人开始相互指导行为)和导师(之前成功地改变了自己的行为的人，指导刚刚开始改变行为的患者)。业余教练还没有接受过肥胖症治疗测试。唯一具有客观结果的试验是在糖尿病管理领域，结果表明同行可能比导师更有效。同样，社会比较理论的研究结果表明，与“相似”的目标(例如，同龄人)进行横向比较可能会比与“更成功的”目标(例如，导师)向上比较更能促进动机和健康行为的改变，因为与成功的目标进行比较会导致挫折感和阻碍表现。尽管社会比较理论是自然契合的，但它并没有被用来理解同伴和导师健康教练对健康结果的影响。此外，这两种类型的业余教练还没有在任何领域进行直接比较。我们进行了一项为期6个月的先导性研究，测试同伴和导师健康教练的减肥效果。参与者接受了团体行为减肥计划(BWL)，并被随机分配给同伴或导师健康教练。BWL治疗包括减少接触时间表；疗程为每周一次，持续6周，每两周一次，此后每月一次。在小组没有见面的那几周，参与者通过电子邮件将他们一周的体重、卡路里和活动信息发送给他们的教练，并收到反馈。结果令人印象深刻。对教练协议的遵从性非常好。与Mentor条件相比，Peer条件下的减肥效果更好(-8.7千克比-5.3千克)。此外，同伴参与者与他们的教练进行横向比较，而导师参与者从事向上比较，横向比较与更大的减肥结果相关。这些初步发现提供了强有力的证据：1)非专业健康教练治疗肥胖症是可行的；2)同伴健康教练可能会产生特别令人印象深刻的减肥效果；3)社会比较过程可能在同伴和导师健康教练的治疗结果中发挥重要作用。我们建议测试非专业健康教练来治疗肥胖症。参与者将被随机分为BWL+Peer、BWL+Mentor或单独BWL。BWL将减少联系计划；会议将在6周内每周举行一次，在6周内每两周举行一次，在其余9个月内每月举行一次。在该小组不见面的几周内，同行和导师参与者将通过电子邮件将他们的进度发送给他们的教练并收到反馈。我们假设，与BWL+Mentor和BWL单独使用相比，BWL+Peer Coach在12个月内会产生更好的减肥效果，并且Peer和Mentor在社会比较方向上会有所不同。如果这些假设得到支持，我们将探索社会比较方向是否会在同伴和导师研究小组之间中介12个月的减肥结果。该项目测试了一种新的、有理论基础、可传播的肥胖治疗方法。如果成功，这种方法可能会为目前的肥胖症治疗努力提供大量信息。