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明显反弹。虽然影响长期减肥维持（WLM）的生物，行为和环境因素很复杂，但很明显，促进WLM的行为和行为与初始减肥所需的行为和行为有很大不同。然而，我们目前缺乏一个明确的概念框架，整合和组织与WLM相关的行为，环境，社会和文化因素。此外，非裔美国人和白人的减肥治疗结果不同，非裔美国人最初减肥较少，而白人经历了更大的长期体重反弹。然而，治疗反应中这些人种/种族差异的原因尚不清楚。因此，本项目的目标是提高我们对与WLM相关的因素的理解，并为非洲裔美国人和白人恢复体重，他们以前实现了临床上有意义的体重减轻（即，>5%重量减少）。通过利用有效的方法，新的调查WLM，包括名义组技术（NGT），卡片分类任务，认知映射，我们将研究与成功的WLM以及体重恢复的非洲裔美国人和白人之间的因素。通过从几项正在进行的减肥研究中招募，包括PI目前的K23 WLM计划随机对照试验，我们将获得足够数量的先前实现减肥的个体。特别是，我们将针对四组参与者：1）非裔美国人减肥维持者，2）非裔美国人体重恢复者，3）白色减肥维持者，4）白色体重恢复者。通过NGT，非裔美国人和白色减肥维护者和恢复者将生成全面的和潜在的文化特定的促进者和WLM障碍列表（目标#1）。然后，这些促进因素和障碍将被优先考虑，并由参与者通过卡片分类任务组织成有意义的类别，这些任务将被纳入聚类分析方法和认知映射，以制定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治疗的差异，并指导未来制定文化定制的WLM干预措施。

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.