Understanding Racial and Ethnic Differences in Weight Loss Maintenance and Regain

项目总结 减肥干预可以产生临床上有意义的减肥效果，尽管大多数人 经历治疗后体重显著回升。而生物、行为和环境 影响长期减肥的因素是复杂的，很明显，行为和 促进WLM的增强剂与最初减肥所需的增强剂有很大不同。然而，我们目前缺乏 一个明确的概念框架，集成和组织行为、环境、社会和 与口碑相关的文化因素。此外，非洲裔美国人和非裔美国人的减肥治疗结果不同 白人，非裔美国人最初体重下降较少，而白人长期体重较高 重获新生。然而，这些种族/民族在治疗反应上存在差异的原因尚不清楚。因此， 这个项目的目标是提高我们对与WLM和体重恢复相关的因素的理解 非裔美国人和白人，他们以前实现了临床上有意义的体重减轻(即体重5% 减少)。通过使用新的验证方法来研究WLM，包括名义群 技术(NGT)、卡片分类任务和认知图谱，我们将检查与以下相关的因素 成功的WLM以及非裔美国人和白人的体重恢复。通过从几个人中招聘 正在进行的减肥研究，包括PI目前的K23随机对照WLM计划试验，我们 将可以接触到足够数量的以前实现减肥的个人。特别是，我们将 目标四组参与者：1)非洲裔美国人减肥维持者，2)非洲裔美国人体重 重获者，3)白色减肥者，和4)白色增重者。通过NGT，非洲 美国和白色减肥者和恢复者将产生全面的和潜在的 WLM的促进者和障碍的文化特定清单(目标1)。这些促进者和障碍将成为 参与者通过卡片分类任务确定优先顺序并组织成有意义的类别，这将是 包括在聚类分析方法和认知图谱中，以开发WLM的概念框架 非裔美国人和白人(目标2)。这项研究的发现将有助于我们了解 对减肥和WLM治疗的回应，并指导文化定制WLM的未来发展 干预措施。

PROJECT SUMMARY Weight loss interventions can produce clinically meaningful weight reductions, although most individuals experience significant weight regain following treatment. While the biological, behavioral, and environmental factors influencing long-term weight loss maintenance (WLM) are complex, it is clear that behaviors and reinforcers facilitating WLM differ greatly from those required for initial weight loss. However, we currently lack a well-specified conceptual framework that integrates and organizes behavioral, environmental, social, and cultural factors related to WLM. Additionally, weight loss treatment outcomes differ for African Americans and Whites, with African Americans losing less weight initially and Whites experiencing greater long-term weight regain. However, the reasons for these racial/ethnic differences in treatment response are unclear. Therefore, the goal of this project is to improve our understanding of factors associated with WLM and weight regain for African Americans and Whites who previously achieved clinically meaningful weight loss (i.e., >5% weight reduction). By utilizing validated methods novel to the investigation of WLM, including the nominal group technique (NGT), card-sorting tasks, and cognitive mapping, we will examine factors associated with successful WLM as well as weight regain among African Americans and Whites. By recruiting from several ongoing weight loss studies, including the PI's current K23 randomized controlled trial of a WLM program, we will have access to sufficient numbers of individuals who previously achieved weight loss. In particular, we will target four groups of participants: 1) African American weight loss maintainers, 2) African American weight regainers, 3) White weight loss maintainers, and 4) White weight regainers. Through the NGT, African American and White weight loss maintainers and regainers will generate comprehensive and potentially culturally-specific lists of facilitators and barriers to WLM (Aim #1). These facilitators and barriers will then be prioritized and organized into meaningful categories by participants through card-sorting tasks, which will be included in cluster analytic methods and cognitive mapping to develop conceptual frameworks of WLM for African Americans and Whites (Aim #2). Findings from this study will help us understand differences in response to weight loss and WLM treatments and guide the future development of culturally-tailored WLM interventions.