Understanding Racial and Ethnic Differences in Weight Loss Maintenance and Regain

描述(由申请人提供)：减肥干预可以产生临床上有意义的体重减轻，尽管大多数人在治疗后体重显著回升。虽然影响长期减肥的生物、行为和环境因素很复杂，但很明显，促进长期减肥的行为和增强剂与最初减肥所需的行为和增强剂有很大不同。然而，我们目前缺乏一个明确的概念框架来整合和组织与WLM相关的行为、环境、社会和文化因素。此外，非洲裔美国人和白人的减肥治疗结果不同，非洲裔美国人最初体重减轻较少，而白人经历更大的长期体重恢复。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，这些因素与之前取得临床意义的减肥(即减重5%)的非裔美国人和白人的体重恢复有关。通过利用经过验证的新方法来研究WLM，包括名义小组技术(NGT)、卡片分类任务和认知图谱，我们将检查与成功的WLM相关的因素以及非裔美国人和白人的体重恢复。通过从几项正在进行的减肥研究中招募成员，包括PI目前的K23随机对照WLM计划试验，我们将有机会获得足够数量的以前实现减肥的个人。特别是，我们将针对四组参与者：1)非裔美国人减肥保持者，2)非裔美国人增重者，3)白人减肥者，和4)白人增重者。通过NGT，非裔美国人和白人减肥维持者和回收者将生成全面的、可能具有文化针对性的WLM促进者和障碍名单(目标1)。然后，参与者将通过卡片分类任务对这些促进者和障碍进行优先排序，并将其组织成有意义的类别，这些类别将被包括在集群分析方法和认知图谱中，以制定针对非裔美国人和白人的WLM概念框架(目标2)。这项研究的结果将帮助我们了解减肥和WLM治疗的反应差异，并指导针对文化定制的WLM干预措施的未来发展。

DESCRIPTION (provided by applicant): 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.