Prevention of Obesity at Universities:A Randomized Trial

描述（由申请人提供）：由于肥胖已达到流行病的程度，导致显著的发病率和死亡率，并且难以治疗，因此针对这一公共卫生问题制定预防方案至关重要。不幸的是，大多数普遍的预防计划并没有降低未来体重增加的风险。因此，我们决定针对一小部分人——进入大学的克制饮食的女性，她们可能有独特的动机来长期改变她们的饮食和活动水平，从而降低她们患肥胖症的风险。在拟议的大学体重控制计划（CWCP）中，青少年女性被教导如何减少食物的份量和能量密度，并增加体育活动以防止体重增加。干预利用来自社会和临床心理学的说服原则（例如，战略性自我表现，动机性访谈）来增加参与者做出持久行为改变的可能性。相对于现有的项目，5期干预是短暂的，这应该有助于传播。一项初步试验（N = 188）发现，在2年的随访中，完成该计划早期版本的参与者发生肥胖的风险（3%）明显低于仅进行评估的对照组（11%），并且在健康饮食和活动水平方面表现出更大的改善。这个项目还减少了饮食失调的症状和负面影响，这很重要，因为这些紊乱的特征是功能障碍和不良后果。因此，我们建议在两所当地大学进行一项大规模的随机试验，以增强这种有针对性的肥胖预防计划的版本。我们将随机抽取350名17-19岁的大一女生作为控制组或实验组，随访2年。我们将测试CWCP，相对于没有治疗的控制条件，是否导致(1)降低体脂增加和肥胖发生的风险，(2)改善能量摄入和饮食的营养成分，(3)增加体力活动，(4)减少饮食失调和抑郁症状，以及(5)降低几种医疗危险因素的水平。

DESCRIPTION (provided by applicant): Because obesity is reaching epidemic proportions, results in marked morbidity and mortality, and is resistant to treatment, it is vital to develop prevention programs for this public health problem. Unfortunately, most universal prevention programs have not reduced the risk for future weight gain. Thus, we decided to target a subset of individuals-female restrained eaters entering college-who might be uniquely motivated to make lasting changes to their diet and activity level that would decrease their risk for obesity onset. In the proposed College Weight Control Program (CWCP), adolescent females are taught methods to reduce the portion size and energy density of their food choices and to increase their physical activity to prevent weight gain. The intervention utilizes persuasion principles from social and clinical psychology (e.g., strategic self-presentation, motivational interviewing) to increase the likelihood that participants will make lasting behavioral changes. The 5-session intervention is brief relative to extant programs, which should facilitate dissemination. A preliminary trial (N = 188) found that participants who completed an earlier version of this program were at significantly lower risk for obesity onset (3%) over a 2-year follow-up relative to assessment-only controls (11%) and showed greater improvements in healthy eating and activity level. This program also reduced eating disorder symptoms and negative affect, which is important because these disturbances are marked by functional impairment and adverse outcomes. Accordingly, we propose to conduct a large-scale randomized trial of an enhanced version of this targeted obesity prevention program at 2 local universities. We will randomly assign 350 female restrained eaters (aged 17-19) during their freshman year to the control or experimental group and follow them for 2 years. We will test whether the CWCP, relative to a no-treatment control condition, results in (1) decreased risk for gain of body fat and onset of obesity, (2) improvements in energy intake and the nutritional composition of the diet, (3) increases in physical activity, (4) decreased eating disorder and depressive symptoms, and (5) reduced levels of several medical risk factors.