Improving Weight Loss Maintenance through Alternative Schedules of Treatment

描述（由申请人提供）： 该K23奖的候选人是一名初级教员，其长期目标是从事学术研究，重点是改善肥胖治疗后的减肥维持，并将研究成果传播到应用临床环境中。为了实现这一目标，该奖项的具体培训目标包括：1）发展在应用临床环境中实施的延长护理减肥维持干预措施的交付和评估方面的专业知识（即，管理式护理），2）开发用于评估维持干预措施的研究方法和统计方法的专业知识，3）扩大对肥胖和体重减轻的生物/生理方面的理解，4）开发维持计划成本效益评估的专业知识，以及5）开发R 01应用程序，以进一步检查应用环境中维持体重减轻的创新和有效方法。为了实现这些目标，候选人提出了一个为期五年的培训计划下的主要指导博士迈克尔佩里，在肥胖和减肥维持的成就研究员。导师团队包括额外的教师，他们具有将减肥计划传播到管理式护理环境，医疗保健计划成本分析，减肥的生物和生理效应以及减肥维持试验的生物统计学和方法学方法的专业知识。培训活动包括研究生课程、国家讲习班/研讨会、导师的教学指导以及参加现场观摩/培训。该培训计划将为候选人提供解决一个重要研究领域的技能，因为治疗后体重反弹很常见，而以前的维持计划只取得了一定的成功。特别是，该奖项的研究计划包括调查不同时间表的后续接触对减肥维持的影响。在管理式护理环境中提供的初始体重减轻计划中实现>5%体重减轻的参与者将被随机分配到12个月的延长护理维持试验中，包括1）集群/活动计划，或2）自我导向比较条件。有各种各样的经验，理论和临床证据表明，集群/运动的方法来延长护理可能会改善减肥的维持，虽然这种方法还没有经验评估。考虑到目前减肥维持策略的局限性，这种研究对于潜在地减少肥胖治疗后的体重反弹是新颖和重要的。

DESCRIPTION (provided by applicant): The candidate for this K23 Award is a junior faculty member whose long-term goal is to have an academic research career focused on the improvement of weight loss maintenance following obesity treatment and the dissemination of research findings into applied clinical settings. In order to achieve this goal, specific training objectives for this award include: 1) develop expertise in the delivery and evaluation of extended care weight loss maintenance interventions as they are implemented in applied clinical settings (i.e., managed care), 2) develop expertise in the research methodology and statistical approach for evaluating maintenance interventions, 3) expand understanding of biological/physiological aspects of obesity and weight loss, 4) develop expertise in the evaluation of maintenance programs' cost-effectiveness, and 5) develop an R01 application to further examine innovative and effective approaches to weight loss maintenance in applied settings. To achieve these objectives, the candidate proposes a five-year training program under the primary mentorship of Dr. Michael Perri, an accomplished researcher in obesity and weight loss maintenance. The mentorship team includes additional faculty members with expertise in the dissemination of weight loss programs to managed care settings, cost analysis of healthcare programs, biological and physiological effects of weight loss, and biostatistical and methodological approaches to weight loss maintenance trials. Training activities include graduate coursework, national workshops/seminars, didactic instruction from mentors, and participation in on-site shadowing/training. This training plan will provide the candidate with the skills to address an important area of research, as weight regain following treatment is common and previous maintenance programs have achieved only modest success. In particular, the research plan for this award includes an investigation of the effects of differing schedules of follow-up contacts for weight loss maintenance. Participants achieving >5% weight loss in an initial weight loss program provided in a managed care setting will be randomized into a 12-month extended care maintenance trial, including 1) a clustered/campaign program, or 2) a self-directed comparison condition. There is a variety of empirical, theoretical, and clinical evidence to suggest that a clustered/campaign approach to extended care may improve weight loss maintenance, although this approach has not been empirically evaluated. Given the limitations associated with current weight loss maintenance strategies, such research is novel and important for potentially minimizing weight regain following obesity treatment.