A State-Wide Initiative to Spread Effective Behavioral Weight Loss Strategies

描述(申请人提供)：肥胖是一个主要的公共健康问题。行为减肥计划已被证明在减轻体重和预防肥胖的医学并发症方面取得了成功。有必要开发具有成本效益的方法来传播这些减肥干预措施。该项目评估了一种传播减肥干预措施的创新方法。它利用一个名为“塑造罗德岛”的全州范围的自给自足的计划，作为招募大量参与者参加该计划的一种手段，并将该计划与有效的行为体重控制策略相结合，以改善减肥结果。Shape-Up Rhode Island是一个为期12周的计划，旨在通过基于互联网的团队比赛帮助罗德岛人减肥和增加活动，该比赛在2009年招募了超过13,000名参与者。为了避免显著增加人员成本或参与者的负担，Shape-Up Rhode Island计划将通过行为减肥干预得到加强，包括(1)通过基于糖尿病预防计划和展望的每周多媒体行为课程提供关于饮食、锻炼和行为策略的教育，参与者可以在他们的计算机上观看；(2)通过提交每周自我监测记录和计算机生成的个性化反馈来加强问责。这项强化干预的初步研究表明，整形RI的参与者很好地坚持了这些添加的成分，并且增强计划显著改善了整形RI计划中的体重减轻。我们建议对600名Shape-Up Rhode Island参与者进行随机对照试验，他们将被随机分配接受为期12周的标准Shape-Up Rhode Island计划或增强计划，其中不仅包括标准Shape-Up Rhode Island计划，还包括每周视频行为课程和每周自动反馈。主要的假设是，增强计划将在12周时改善体重减轻。次要目标是比较治疗对6个月和12个月后体重减轻5%的参与者的百分比，以及与体重控制相关的行为变化，并对两种计划进行成本效益和成本效用分析。这一创新的干预措施使用了全州范围的外展运动，并结合了成功减肥的有效行为策略，有可能成为治疗肥胖症的重要公共卫生模式。 公共健康相关性：行为减肥计划可以成功地减轻体重，但这些计划只适用于有限数量的超重和肥胖个人。该项目评估了一种独特的减肥方法，该方法将自我维持的减肥运动(用于外展)与行为减肥战略和战略方面的培训相结合，以增加责任感(以提高减肥成功率)。这种创新的组合有可能成为传播体重控制干预措施的具有成本效益的模式。

DESCRIPTION (provided by applicant): Obesity is a major public health problem. Behavioral weight loss programs have been shown to be successful in reducing body weight and preventing the onset of medical complications of obesity. There is a need to develop cost-effective approaches to disseminating these weight loss interventions. This project evaluates an innovative approach to disseminating weight loss interventions. It uses a self-sustaining statewide program called "Shape Up Rhode Island", as a means of recruiting large numbers of participants to the program and combines this program with effective behavioral weight control strategies to improve the weight loss outcome. Shape-Up Rhode Island is a 12 week program to help Rhode Islanders lose weight and increase activity through an Internet delivered team-based competition, which recruited over 13,000 participants in 2009. To avoid markedly increasing personnel costs or participant burden, the Shape-Up Rhode Island program will be enhanced with a behavioral weight loss intervention including (1) education about diet, exercise and behavior strategies delivered via weekly multi-media behavioral lessons based on the Diabetes Prevention Program and Look AHEAD, that can be viewed by the participant on their computer; and (2) increased accountability through submission of weekly self-monitoring records and computer-generated individualized feedback. A pilot study of this enhanced intervention indicated that participants in Shape-Up RI adhered well to these added components and that the enhanced program significantly improved weight losses in the Shape-Up RI program. We propose to conduct a randomized controlled trial with 600 Shape-Up Rhode Island participants who will be randomly assigned to receive the 12-week standard Shape-Up Rhode Island program or an enhanced program, which includes not only the standard Shape-Up Rhode Island program, but also weekly video behavioral lessons and weekly automated feedback. The primary hypothesis is that the enhanced program will improve weight losses at week 12. Secondary aims are to compare the treatments on percent of participants achieving a 5% weight loss, on 6 and 12-month follow-up, and on behavior changes related to weight control, and to conduct cost-effective and cost-utility analyses comparing the two programs. This innovative intervention, which uses a statewide campaign for outreach combined with effective behavioral strategies for weight loss success, has the potential to be an important public health model for the treatment of obesity. PUBLIC HEALTH RELEVANCE: Behavioral weight loss programs can successfully reduce body weight, but these programs are available to limited numbers of overweight and obese individuals. This project evaluates a unique weight loss approach that combines a self-sustaining weight loss campaign (for outreach) with training in behavioral weight loss strategies and strategies to increase accountability (to improve weight loss success). This innovative combination has the potential to be a cost-effective model for disseminating weight control interventions.