Engaging self-regulation targets to understand the mechanisms of behavior change and improve mood and weight outcomes

参与自我调节目标以了解行为改变的机制并改善情绪和体重结果

基本信息

批准号：
9339342
负责人：
Jun Ma
金额：
$ 9.52万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-15 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9339342
关键词：
Adherence Adult Affect Antidepressant adherence Behavior Behavior Therapy Behavioral Behavioral Sciences Biological Biological Assay Body Weight decreased Brain Cardiovascular Diseases Cardiovascular system Characteristics Cognitive Data Analyses Depressed mood Diabetes Mellitus Diet Diet Research Disease Disease remission Early treatment Educational workshop Effectiveness Emotional Equilibrium Funding Health Health behavior Health behavior change Health behavior outcomes Human Individual Informal Social Control Intervention Intervention Studies Life Style Maintenance Measures Medical Medicine Mental Depression Moods Neurosciences Obesity Outcome Participant Patients Pharmaceutical Preparations Pharmacotherapy Phase Physical activity Physiological Population Primary Health Care Process Randomized Randomized Controlled Trials Regimen Regulation Research Science Series Subgroup Testing Time Training Waiting Lists Weight Weight maintenance regimen Woman adverse outcome base behavior change burden of illness depressive symptoms disability evidence base follow-up good diet health disparity improved insight lifetime risk men multiple chronic conditions obesity treatment pilot trial population health problem solving therapy programs prototype psychologic relating to nervous system research study response symposium theories treatment as usual treatment response virtual laboratory

项目摘要

DESCRIPTION (provided by applicant): Background: Obesity affects 36% of US women and men and increases lifetime risk for diabetes and cardiovascular disease. Similarly, depression affects 20% of US women and 13% of men and is the leading cause of disability worldwide. Further, the 2 disorders have a bidirectional positive relationship. Proven behavioral interventions to treat obesity and depression exist; however, the underlying biological mechanisms remain unknown. This lack of understanding significantly hampers efforts to optimize the effectiveness of behavioral interventions and limits their dissemination and implementation into widespread practice to curtail the adverse consequences of obesity and depression and promote population health. Rapid advances in human neuroscience and behavioral science and integration of the two could provide unique opportunity to fill this gap. Objective: Leveraging a recently funded 2-year randomized controlled trial ("RAINBOW" target n=404; PI Dr. Jun Ma) of a first-ever integrated treatment for comorbid obesity and depression in primary care that uniquely combines 2 nationally recognized behavioral interventions, we propose a 2-phased project to identify, validate and refine a set of assays to measure self-regulation targets; and to engage these targets to optimize behavioral treatment of obesity and depression. Specific Aims: In the UH2 phase, we will (1) Conduct secondary data analysis and hold workshops and a symposium to finalize selection of self-regulation targets and assays for testing; (2) Leverage the RAINBOW intervention to engage identified targets; and (3) Verify target engagement across multiple domains (neural, physiological, behavioral, psychological), settings (laboratory, virtual, and naturalistic), and time points (0, 4 weeks, 6, 12 and 24 months) Transitional milestones are to (1) Establish assay(s) that reliably and accurately measure the identified targets; (2) Demonstrate malleability of the self-regulation target(s) in response to th RAINBOW integrated treatment; and (3) Identify self-regulation profile(s) that predict treatment response in health behaviors (medical regimen adherence, physical activity, diet) and outcomes (weight, depression). In the UH3 phase, we will conduct a pilot randomized controlled trial in which an additional 100 obese and depressed adults will be randomized to intervention or wait-list control and assessed at baseline, 4 weeks and 6 months. Intervention subjects will receive the first 4 weeks of the RAINBOW intervention, followed by target-guided tailoring of the intervention components in order to optimize target engagement and enhance behavioral change based on their individual self-regulation profile during the first 4 weeks. We will use the insights from intervention subjects to then further refine the tailoring strategies for the waitlis subjects. Implications: This research will provide a toolkit of well-validated assays of self-regulation targets important for health behavior change, as well as target- guided personalization of intervention strategies, in the treatment of comorbid obesity and depression. Impact: Given the widespread relevance of these disorders and the targeted health behaviors, this research will be a prototype for treating multiple chronic conditions with profound potential impacts on population health.

描述（由适用提供）：背景：肥胖影响美国36％的男女，并增加了糖尿病和心血管疾病的终生风险。同样，抑郁症会影响美国20％的女性和13％的男性，并且是全球疾病的主要原因。此外，这两种疾病具有双向阳性关系。存在经过验证的治疗肥胖和抑郁的行为干预措施；但是，潜在的生物学机制仍然未知。缺乏理解极大地阻碍了优化行为干预措施的有效性，并将其传播和实施限制为宽度实践，以减少肥胖和抑郁症的不利后果，并促进人口健康。人类神经科学和行为科学的快速进步以及两者的整合可以提供独特的机会来填补这一空白。目的：利用一项最近资助的2年随机对照试验（“彩虹”目标n = 404; pi jun Ma博士），用于在初级保健中对合并症的肥胖和抑郁症进行的首次综合治疗，该治疗唯一地结合了2个全国认可的行为干预措施，我们提出了一个基于2次的项目，以识别，验证，验证和完善综合目标，以衡量和完善自我调查的目标；并参与这些目标以优化肥胖和抑郁症的行为治疗。具体目的：在UH2阶段，我们将（1）进行辅助数据分析并举办研讨会和研讨会，以最终确定自我调节目标和测试测定的选择；（2）利用彩虹干预措施参与确定的目标；（3）验证跨多个领域（神经，物理，行为，心理），设置（实验室，虚拟和自然主义）以及时间点（0、4周，6、6、12和24个月）过渡的里程碑的目标参与的目标是（1）建立可靠，准确地测量确定的目标的测定；（2）证明了自我调节靶标对彩虹综合处理的锻造性；（3）确定预测健康行为治疗反应（医疗方案依从性，体育锻炼，饮食）和结果（体重，抑郁）的自我调节概况。在UH3阶段，我们将进行一项飞行员随机对照试验，其中另外100名肥胖和抑郁症的成年人将被随机分配给干预或等待名单，并在基线，4周零6个月时进行评估。干预受试者将接受彩虹干预的前4周，然后进行干预组件的目标引导调整，以优化目标参与并根据其在头4周内的个人自我调节概况来增强行为改变。我们将利用干预对象的见解来进一步完善含义：这项研究将提供对自我调节目标对健康行为变化重要的自然调节目标的工具包，以及对干预策略的目标指导的个性化，以治疗均匀肥胖和抑郁症。影响：鉴于这些疾病的宽度释放和有针对性的健康行为，这项研究将是治疗多种慢性病，对人群健康产生深远影响的原型。