Afari Niloofar, Cuneo Jessica Gundy, Herbert Matthew, Miller Isabel, Webb-Murphy Jennifer, Delaney Eileen, Peters Joshua, Materna Karla, Miggantz Erin, Godino Job, Golshan Shahrokh, Wisbach Gordon
VA San Diego Healthcare System, San Diego, CA, USA.
University of California, San Diego, La Jolla, CA, USA.
Contemp Clin Trials Commun. 2019 Jul 10;15:100408. doi: 10.1016/j.conctc.2019.100408. eCollection 2019 Sep.
Overweight/obesity and inadequate fitness in active duty personnel impact the wellbeing of service members and have significant costs for military readiness and budget. ShipShape (SS), the Navy's weight management program, was designed to promote nutritional, behavioral, and exercise education to service members. Although SS is an evidence-based program, about half of those who complete the program pass the Body Composition Assessment (BCA), one part of the Navy's comprehensive Physical Fitness Assessment (PFA). SS may not fully address underlying behavioral, psychological, and emotional barriers that influence poor eating and exercise habits. A novel solution to improve outcomes is to incorporate acceptance and commitment therapy (ACT) to promote mindful awareness of present moment experiences, improve psychological flexibility, and support commitment to behavior change. This paper describes a cohort-randomized controlled trial of ACT-enhanced SS (ACT + SS) compared to the standard SS-only program. Active duty service members referred to the SS program are randomized to receive 8-weekly ACT + SS or SS-only group interventions. Our aims are to: 1) determine the effectiveness of ACT + SS compared to SS-only; 2) examine psychological flexibility as a mechanism underlying intervention response; and 3) explore potential moderators of intervention response. The primary outcome is weight, one of the key components of the BCA; secondary outcomes include Body Mass Index (BMI), body fat %, self-reported BCA results, physical activity, problematic eating, and quality of life. We have designed a cohort-randomized trial with interventions that are pragmatically implemented in a real-life military setting, and outcomes that are immediately relevant to service members and leadership.
现役军人的超重/肥胖和体能不足会影响军人的健康，并给军事准备和预算带来巨大成本。海军的体重管理计划“塑造体型”（ShipShape，简称SS）旨在向军人推广营养、行为和运动教育。尽管SS是一个基于证据的计划，但完成该计划的人中约有一半通过了身体成分评估（BCA），这是海军综合体能评估（PFA）的一部分。SS可能无法完全解决影响不良饮食和运动习惯的潜在行为、心理和情感障碍。一种改善结果的新方法是纳入接受与承诺疗法（ACT），以促进对当下体验的正念觉知，提高心理灵活性，并支持对行为改变的承诺。本文描述了一项队列随机对照试验，将ACT强化的SS（ACT + SS）与标准的仅SS计划进行比较。被推荐参加SS计划的现役军人被随机分配接受为期8周的ACT + SS或仅SS组干预。我们的目标是：1）确定ACT + SS与仅SS相比的有效性；2）将心理灵活性作为干预反应的潜在机制进行研究；3）探索干预反应的潜在调节因素。主要结果是体重，这是BCA的关键组成部分之一；次要结果包括体重指数（BMI）、体脂百分比、自我报告的BCA结果、身体活动、问题饮食和生活质量。我们设计了一项队列随机试验，其干预措施在现实生活中的军事环境中实际实施，结果与军人和领导层直接相关。
