Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Ethn Health. 2021 Feb;26(2):251-263. doi: 10.1080/13557858.2018.1493435. Epub 2018 Jul 2.
African Americans (AA) are often underrepresented and tend to lose less weight than White participants during the intensive phase of behavioral obesity treatment. Some evidence suggests that AA women experience better maintenance of lost weight than White women, however, additional research on the efficacy of extended care programs (i.e. continued contacts to support the maintenance of lost weight) is necessary to better understand these differences. The influence of race on initial weight loss, the likelihood of achieving ≥5% weight reduction (i.e. extended care eligibility), the maintenance of lost weight and extended care program efficacy was examined in 269 AA and White women (62.1% AA) participating in a 16-month group-based weight management program. Participants achieving ≥5% weight reduction during the intensive phase (16 weekly sessions) were randomized to a clustered campaign extended care program (12 sessions delivered in three, 4-week clusters) or self-directed control. In adjusted models, race was not associated with initial weight loss (= 0.22) or the likelihood of achieving extended care eligibility (odds ratio 0.64, 95% CI [0.29, 1.38]). AA and White women lost -7.13 ± 0.39 kg and -7.62 ± 0.43 kg, respectively, during initial treatment. There were no significant differences in weight regain between AA and White women (= 0.64) after adjusting for covariates. Clustered campaign program participants (AA: -6.74 ± 0.99 kg, White: -6.89 ± 1.10 kg) regained less weight than control (AA: -5.15 ± 0.99 kg, White: -4.37 ± 1.04 kg), equating to a 2.12 kg (= 0.03) between-group difference after covariate adjustments. Weight changes and extended care eligibility were comparable among all participants. The clustered campaign program was efficacious for AA and White women. The high representation and retention of AA participants may have contributed to these findings.
非裔美国人（AA）在行为肥胖治疗的强化阶段往往代表性不足，而且体重减轻的幅度也低于白人参与者。有一些证据表明，AA 女性在保持减肥效果方面要好于白人女性，然而，为了更好地理解这些差异，需要对扩展护理计划（即继续联系以支持减肥效果的保持）的疗效进行更多的研究。种族对初始体重减轻、达到≥5%体重减轻（即扩展护理资格）的可能性、减肥的维持以及扩展护理计划的疗效的影响，在 269 名参与为期 16 个月的基于小组的体重管理计划的 AA 和白人女性（62.1%为 AA）中进行了检查。在强化阶段（16 周的每周会议）达到≥5%体重减轻的参与者被随机分配到分组运动扩展护理计划（在三个 4 周的群组中提供 12 次会议）或自我指导的对照组。在调整后的模型中，种族与初始体重减轻（=0.22）或达到扩展护理资格的可能性（比值比 0.64，95%CI[0.29，1.38]）无关。AA 和白人女性在初始治疗期间分别减轻了-7.13±0.39kg 和-7.62±0.43kg。调整了协变量后，AA 和白人女性之间的体重反弹没有显著差异（=0.64）。分组运动计划参与者（AA：-6.74±0.99kg，白人：-6.89±1.10kg）比对照组（AA：-5.15±0.99kg，白人：-4.37±1.04kg）减轻的体重更少，调整协变量后，组间差异为 2.12kg（=0.03）。所有参与者的体重变化和扩展护理资格都相似。分组运动计划对 AA 和白人女性均有效。AA 参与者的高代表性和保留率可能促成了这些发现。
