Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA.
Obesity (Silver Spring). 2013 Apr;21(4):712-7. doi: 10.1002/oby.20270.
We have previously shown that racial composition of behavioral intervention groups does not affect achieved weight loss. However, it is unclear if the race of the interventionist affects intervention outcomes. The objective of this analysis is to estimate the impact of race concordance between participant and interventionist on weight change in the initial weight loss phase (phase I) of the Weight Loss Maintenance trial (WLM).
A total of 1,685 overweight or obese adults (BMI 25-45 kg/m(2) ) who were taking medication for hypertension and/or dyslipidemia participated in phase I of the WLM trial. All participants received a 6-month intensive behavioral intervention in groups of 15-20 facilitated by a trained interventionist. The main outcome is change in weight at 6 months.
Participants were on average 55 years of age, 67% female and 44% African American (AA). Three of seventeen interventionists were AA, 14 were non-AA. Seventy-three percent of participants shared race concordance with the interventionist. There was a small but statistically significant difference in weight change of participants who were the same race as the interventionist (-5.84 kg, s.e. 0.17) as compared with those who were not race concordant (-5.04 kg, s.e. 0.33), a difference of 0.8 kg, (P = 0.04). The impact of concordance on weight change differed by race (i.e., interaction of race and concordance was significant, P = 0.02).
In a post hoc analysis of a group-based behavioral intervention, race concordance for non-AA participants was associated with slightly greater weight loss. Race concordance was not associated with weight loss for AA participants.
我们之前的研究表明，行为干预组的种族构成并不影响减肥效果。然而，干预者的种族是否影响干预结果尚不清楚。本分析的目的是评估参与者与干预者之间的种族一致性对减肥维持试验（WLM）初始体重减轻阶段（阶段 I）体重变化的影响。
共有 1685 名超重或肥胖成年人（BMI 25-45 kg/m²）参加了 WLM 试验的阶段 I。所有参与者都接受了为期 6 个月的强化行为干预，由经过培训的干预者在 15-20 人的小组中进行。主要结局是 6 个月时的体重变化。
参与者平均年龄为 55 岁，67%为女性，44%为非裔美国人（AA）。17 名干预者中有 3 人为 AA，14 人为非 AA。73%的参与者与干预者具有种族一致性。与非 AA 参与者相比，与干预者种族一致的参与者体重变化略小但具有统计学意义（-5.84kg，s.e. 0.17 与 -5.04kg，s.e. 0.33），差异为 0.8kg，（P=0.04）。一致性对体重变化的影响因种族而异（即，种族和一致性的交互作用具有统计学意义，P=0.02）。
在基于群体的行为干预的事后分析中，非 AA 参与者的种族一致性与体重减轻略大相关。种族一致性与 AA 参与者的体重减轻无关。
