Dissemination of the Look Ahead Weight Management Treatment in the Military

描述（由申请人提供）：本申请是响应PAR-12-048，“肥胖症、糖尿病和慢性肾脏疾病在军事人群中的预防和治疗”。美国现役军人也反映了平民肥胖率的显著上升。2005年进行的一项调查显示，在美国现役军人中，61%的男性和39%的女性的身体质量指数被归类为超重（身体质量指数[BMI] bbb25 kg/m2）， 12%的现役军人肥胖（BMI bbb30 kg/m2），而1995年这一比例还不到5%。鉴于肥胖症在全国范围内的流行仍在继续，人们预计今天的流行率会更高。虽然《公告》强调了在军事人群中开展研究的优势，但也存在许多后勤、实际、指挥系统、哲学和其他挑战，阻碍了军事领域的健康促进和其他研究。幸运的是，我们的研究团队在军队中进行健康促进/疾病预防方面有着悠久的历史，并且有一个军事联络人（Wayne Talcott，博士，Col， USAF[退休]），他帮助确保我们多个项目的有效日常运行。军队中成功研究的关键是解决重大的健康促进问题（例如，吸烟、酗酒、肥胖），这些问题(a)对军队来说代价高昂；最重要的是，军事准备的障碍（即在战斗或非战斗情况下完成工作的能力）。鉴于肥胖是军事准备的障碍（这是军队的一个重要问题），需要在这一高危人群中进行肥胖干预，以及美国军队肥胖治疗研究的缺乏，我们提出以下具体目标：1)在适应军人独特的生活方式和环境的同时，将“展望”减肥干预转化为超重/肥胖的美国现役军人；(2)将520名参与者随机分为前瞻性强化生活方式干预组（ILI）和饮食和体育活动教育组（Diet/PA Ed）。这个Look Ahead翻译的饮食/PA Ed条件不是安慰剂对照组，而是一个强调营养，运动和支持的积极信息组（类似于最初Look Ahead试验中的饮食支持和教育对照组）。(3)评估前瞻性减肥干预在该人群中的长期（1年）疗效。干预的结果如果成功，将很容易传播到整个美国军队，因为这个项目旨在克服障碍，利用独特的减肥促进者

DESCRIPTION (provided by applicant): This application is in response to PAR-12-048, "Prevention and Treatment of Obesity, Diabetes, and Chronic Kidney Disease in Military Populations". Active U.S. military personnel have mirrored the marked civilian increased prevalence in obesity. A survey conducted in 2005 reported that 61% of men and 39% of women serving in the active component of the U.S. military had a body mass index that classified them as overweight (Body Mass Index [BMI] > 25 kg/m2) and 12% of active service members were obese (BMI>30 kg/m2), up from less than 5% in 1995. Given that the national epidemic of obesity continues, one would expect those prevalence rates to be even higher today. While the Announcement highlights the advantages of conducting research in military populations, there are also many logistical, practical, chain-of-command, philosophical, and other challenges that impede health promotion and other research in the military. Fortunately, our research team has a long history of conducting health promotion/disease prevention in the military and has a military liaison (Wayne Talcott, Ph.D., Col, USAF [retired]) who helps ensure the effective day to day running of our multiple projects. The key to successful research in the military is to address significant health promotion issues (e.g., smoking, alcohol abuse, obesity) that are (a) costly to the military; and (b) most importantly, impediments to military readiness (which is the ability to do one's job in either combat or non-combat situations). Given that obesity is an impediment to military readiness (a vital concern for the military), the need for obesity interventions in this high risk population and the dearth of research on obesity treatments in the U.S. Military, we propose the following specific aims: 1) To translate and tailo the Look Ahead weight loss intervention to the overweight/obese active duty U.S. Military population, while accommodating the lifestyle and environment that is unique to military members; (2) To randomize 520 participants to either the Look Ahead Intensive Lifestyle Intervention (ILI) versus a Diet and Physical Activity Education (Diet/PA Ed) condition. The Diet/PA Ed condition of this Look Ahead translation is not a placebo control group but an active information group that stresses nutrition, exercise and support (similar to the Diet Support and Education control group in the original Look AHEAD trial). (3) To evaluate the long term (one year) efficacy of the Look Ahead weight loss intervention in this population. The results of the intervention if successful will be easily disseminated to the entire U.S. Military as this project s designed to overcome the barriers and exploit the facilitators for weight loss that are unique to a military population. It will also better inform translation of the Look Ahead Rx in civilian populations as well.