PRIDE: Program to Reduce Incontinence by Diet & Exercise

尿失禁是女性的常见问题，它会导致痛苦，降低生活质量。 以及日常运作的戏剧性限制。超重女性患尿病的风险显著增加 大小便失禁和超过65%的大小便失禁妇女超重。来自短期、初步的数据 研究表明，减肥可以显著减少大小便失禁的发作。因此，失重可能 提出了一种很有希望的治疗尿失禁的新方法，这种方法可能会产生一系列 除了减少尿失禁的频率外，更广泛的健康改善。因此，我们 建议将330名患有尿失禁的超重和肥胖妇女(两人各165人)随机分为两组 临床中心)到为期6个月的强化行为体重控制计划或常规护理，以确定 减肥对大小便失禁频率和生活质量的短期影响，最有可能识别女性 从减肥中获益，并开始探索尿失禁的尿动力学机制 体重减轻后的改善。 为了最大限度地减轻体重对尿失禁的持久影响，有必要生产 持续减肥。然而，在肥胖领域，保持体重仍然是一个挑战。因此， 我们建议评估一项创新的、理论指导的体重维持计划，该计划将重点放在 增加对行为改变努力的动力和承诺，并将其与更标准的 注重技能的减肥计划。在完成为期6个月的减肥计划后， 减肥臂将随机接受为期12个月的标准、基于技能的维护计划或 以激励为重点的维护干预。结果包括体重减轻、大小便失禁频率 18个月时的生活质量。如果对大小便失禁的女性有效，那么这种治疗的方法和策略 创新的以动机为重点的维护干预可以在其他肥胖人群中进行检查。 为失禁网络减轻体重-汇集了一组独特的杰出和 在尿失禁、肥胖治疗和多中心合作方面经验丰富的研究人员- 在三个机构进行了积极的临床试验，拟议的研究设计将使我们能够有效地评估 治疗尿失禁的新疗法和增强体重维持的有前景的方法， 并因此为对妇女健康至关重要的几个临床领域作出实质性贡献。

Urinary incontinence Is a commonproblem among women that causesdistress, diminished quality of life and dramatic limitations in daily functioning. Overweight womenare at significantly increased risk of urinary incontinence and over 65% of womenwith incontinence are overweight. Data from short-term, preliminary studies suggestthat weight reduction may significantly reduce incontinence episodes. Thus, weightless may present a promising new approach to urinary incontinence treatment,one likely to produce a cascadeof broader health improvements in addition to reductions in frequencyof urinary incontinence. Therefore, we propose to randomize 330 overweight and obese womenwith urinary incontinence (165 at each of two clinical centers) to a 6-month intensive behavioral weight control programor to usual care to determine the short-term effect of weight loss on frequency of incontinence and quality of life, to identify women most likely to benefit from weight loss and to beginto explore the urodynamicmechanisms underlying incontinence improvement following weight loss. To maximize enduring effects of weight loss on urinary incontinence, it will be necessary to produce sustained weight loss. However, weight maintenance remainsa challenge in the obesity field. Therefore, we propose to evaluate an innovative, theory-guided weight maintenance program that will focus on increasing motivation and commitment to behavior change efforts and comparethis with a more standard, skills-focused weight maintenance program.After completing the 6-month weight loss program,women in the weight loss arm will be randomizedto either a 12-month standard, skill-based maintenance programor to a motivationally-focused maintenance intervention. Outcomes will include weight loss, incontinence frequency and quality of life at 18 months. If effective in women with incontinence, the methods and strategies of this innovative motivationally-focused maintenance intervention can be examined in other obesepopulations. WIN- Weight Reduction for Incontinence Network- brings together a unique group of outstanding and experienced investigators with expertise in urinary incontinence, obesity treatment and multicenter collabora- tive clinical trials at three Institutions, The proposed study design will allow us to efficiently evaluate both a novel treatment for urinary incontinence and a promising approach to enhancement of weight maintenance, and therefore to make substantive contributions to severalclinical arenas critical to women's health.