HealthPartners Institute, Minneapolis, MN, USA.
University of Minnesota, Minneapolis, MN, USA.
Ann Behav Med. 2018 Jan 5;52(1):9-18. doi: 10.1007/s12160-017-9917-x.
An important step toward enhancing the efficacy of weight loss maintenance interventions is identifying the pathways through which successful interventions such as the Keep It Off trial have worked.
This study aimed to assess the viability of mediated relationships between the Keep It Off Guided intervention, conceptually and empirically grounded potential mediators, and weight. Repeated measurement of mediators and weight enabled documentation of the temporal ordering of intervention delivery and changes in mediators and in weight among participants randomized to the Guided intervention or Self-Directed comparison group.
Total, direct, and indirect effects of the Guided intervention on weight change were calculated and tested for significance. Indirect effects were comprised of the influence of the intervention on three change scores for each mediator and the relationship between mediator changes and weight changes 6 months later.
Guided intervention participants regained about 2% less weight over 24 months than Self-Directed participants. Starting daily self-weighing accounted for the largest share of this difference, followed by not stopping self-weighing.
Daily self-weighing mediated 24-month weight loss maintenance.
The trial is registered with ClinicalTrials.gov (Identifier: NCT00702455 www.clinicaltrials.gov/ct2/show/NCT00702455).
提高减肥维持干预效果的一个重要步骤是确定成功干预措施（如 Keep It Off 试验）的作用途径。
本研究旨在评估 Keep It Off 指导干预、基于概念和经验的潜在中介的介导关系的可行性，以及体重之间的关系。对中介和体重进行重复测量，使我们能够记录干预措施的实施时间顺序以及随机分配到指导干预组或自我指导比较组的参与者的中介和体重变化。
计算并测试了指导干预对体重变化的总效应、直接效应和间接效应。间接效应由干预对每个中介的三个变化得分的影响以及中介变化与 6 个月后体重变化之间的关系组成。
在 24 个月的时间里，与自我指导组相比，指导干预组参与者的体重增加量减少了约 2%。开始每天自我称重解释了这一差异的最大部分，其次是不停止自我称重。
每天自我称重介导了 24 个月的体重维持。
该试验在 ClinicalTrials.gov 注册（标识符：NCT00702455 www.clinicaltrials.gov/ct2/show/NCT00702455）。
