Gorin Amy A, Powers Theodore A, Gettens Katelyn, Cornelius Talea, Koestner Richard, Mobley Amy R, Pescatello Linda, Medina Tania Huedo
Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT, 06269, USA.
Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA, USA.
BMC Public Health. 2017 Sep 29;17(1):749. doi: 10.1186/s12889-017-4732-7.
Obesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT), greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one's spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses.
Project TEAMS (Talking about Eating, Activity, and Mutual Support) is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other's eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL) or to 6 months of standard behavioral weight loss treatment (BWL). Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence.
This study addresses the fundamental importance of interpersonal support in weight management by focusing on couples rather than individuals and using a rich theoretical framework to train spouses in supportive behaviors.
Clinicaltrials.gov ; NCT02570009 .
肥胖风险在配偶之间具有共性，但现有的减肥项目侧重于个体而非夫妻双方。鉴于夫妻体重的相互依存关系，通过针对共同减肥以及营造支持长期行为改变的人际环境，体重管理效果可能会得到改善。根据自我决定理论（SDT），在需求支持性环境中，行为的自主自我调节能力更强，治疗效果也更好，这种环境支持个人有意义的选择，并尽量减少批评和控制。相关性分析证实了体重管理中的这些途径，来自配偶或伴侣的需求支持成为减肥成功的一个显著预测因素。现在需要开展研究来建立因果联系，并开发和测试旨在促进配偶需求支持行为的减肥干预措施。
项目TEAMS（谈论饮食、活动和相互支持）是一项随机对照试验，测试一种基于夫妻的干预措施，该措施以自我决定理论为基础，旨在通过培训配偶为彼此的饮食和身体活动行为提供需求支持，从而改变减肥的社会环境。64对夫妻将被随机分为两组，一组接受为期6个月的基于自我决定理论的行为减肥治疗（SDT-WL），另一组接受为期6个月的标准行为减肥治疗（BWL）。夫妻双方将参加为期6个月的每周一次的课程，并在第0、3、6和12个月接受评估。通过加强需求支持，预计SDT-WL比标准行为治疗能增强自主自我调节和感知能力，并带来更大的体重减轻和维持效果。探索性分析将检验自我决定理论过程模型的预测，即需求支持对治疗结果的影响将通过自主自我调节和感知能力来介导。
本研究通过关注夫妻而非个体，并使用丰富的理论框架培训配偶的支持行为，解决了人际支持在体重管理中的根本重要性问题。
Clinicaltrials.gov；NCT02570009 。
