小额激励可提高弱势群体女性的减肥效果。
Small Incentives Improve Weight Loss in Women From Disadvantaged Backgrounds.
机构信息
Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut.
Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
出版信息
Am J Prev Med. 2018 Mar;54(3):e41-e47. doi: 10.1016/j.amepre.2017.11.007. Epub 2018 Jan 12.
INTRODUCTION
Women from lower-income backgrounds have the highest rates of obesity. Thus, effective programs for this high-risk population are urgently needed. Evidence suggests that adding financial incentives to treatment helps to engage and promote health behavior change in lower-income populations; however, this has never been tested in women for obesity treatment. The purpose of this study was to examine whether adding small financial incentives to Internet weight loss treatment yields better weight loss outcomes in women from lower-income backgrounds compared with the same treatment without incentives. Weight losses in lower-versus higher-income women were also compared.
METHODS
Data were pooled from two randomized trials in which women (N=264) received either Internet behavioral weight loss treatment (IBWL) or IBWL plus incentives (IBWL+$). Weight was objectively assessed. Data were collected and analyzed from 2011 to 2017.
RESULTS
Women from lower-income backgrounds had significantly better weight loss outcomes in IBWL+$ compared with IBWL alone (6.4 [SD=4.9%] vs 2.6 [SD=4.6%], p=0.01). Moreover, a greater percentage achieved a ≥5% weight loss in IBWL+$ vs IBWL alone (52.6% vs 38.1%, p=0.01). Interestingly, the comparison between lower-income versus higher-income groups showed that, in IBWL alone, women with lower income achieved significantly poorer weight losses (3.4 [SD=4.2%] vs 4.9 [SD=4.0%], p=0.03). By contrast, in IBWL+$, weight loss outcomes did not differ by income status (5.0 [SD=5.6%] vs 5.3 [SD=3.8%], p=0.80), and a similar percentage of lower- versus higher-income women achieved a ≥5% weight loss (52.6% vs 53.8%, p=0.93).
CONCLUSIONS
An Internet behavioral weight loss program plus financial incentives may be an effective strategy to promote excellent weight losses in women with lower income, thereby enhancing equity in treatment outcomes in a vulnerable, high-risk population. These data also provide important evidence to support federally funded incentive initiatives for lower-income, underserved populations.
简介
来自低收入背景的女性肥胖率最高。因此，迫切需要为这一高危人群制定有效的计划。有证据表明，在治疗中加入经济激励措施有助于吸引和促进低收入人群的健康行为改变；然而，这在针对肥胖症的女性治疗中从未得到过检验。本研究的目的是检验在互联网减肥治疗中加入少量经济激励措施是否会使来自低收入背景的女性比没有激励措施的治疗效果更好，以及与高收入女性相比，低收入女性的减肥效果如何。
方法
数据来自两项随机试验的汇总，其中 264 名女性（N=264）接受了互联网行为减肥治疗（IBWL）或 IBWL 加激励（IBWL+$）。客观评估体重。数据收集和分析于 2011 年至 2017 年进行。
结果
在 IBWL+$中，来自低收入背景的女性体重减轻效果明显优于 IBWL 单独治疗（6.4[SD=4.9%] vs 2.6[SD=4.6%]，p=0.01）。此外，IBWL+$中达到≥5%体重减轻的比例也明显高于 IBWL 单独治疗（52.6% vs 38.1%，p=0.01）。有趣的是，在低收入与高收入组的比较中，在 IBWL 单独治疗中，收入较低的女性体重减轻效果明显较差（3.4[SD=4.2%] vs 4.9[SD=4.0%]，p=0.03）。相比之下，在 IBWL+$中，收入状况对体重减轻结果没有影响（5.0[SD=5.6%] vs 5.3[SD=3.8%]，p=0.80），低收入与高收入女性达到≥5%体重减轻的比例也相似（52.6% vs 53.8%，p=0.93）。
结论
互联网行为减肥计划加经济激励措施可能是促进低收入女性获得良好减肥效果的有效策略，从而增强了在弱势高风险人群中治疗效果的公平性。这些数据还为支持针对低收入、服务不足人群的联邦激励倡议提供了重要证据。
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