William S. Middleton Memorial Veterans Hospital.
Department of Surgery.
Health Psychol. 2020 May;39(5):391-402. doi: 10.1037/hea0000835. Epub 2020 Jan 30.
This study describes early-phase development of a behavioral intervention to reduce weight regain following bariatric surgery. We utilized the Obesity-Related Behavioral Intervention Trials model to guide intervention development and evaluation. We sought to establish recruitment, retention, and fidelity monitoring procedures; evaluate feasibility of utilizing weight from the electronic medical record (EMR) as an outcome; observe improvement in behavioral risk factors; and evaluate treatment acceptability.
The intervention comprised 4 weekly telephone calls addressing behavior change strategies for diet, physical activity, and nutrition supplement adherence and 5 biweekly calls addressing weight loss maintenance constructs. Veterans ( = 33) who received bariatric surgery 9-15 months prior consented to a 16-week, pre-post study. Self-reported outcomes were obtained by telephone at baseline and 16 weeks. Clinic weights were obtained from the EMR 6 months pre- and postconsent. Qualitative interviews were conducted at 16 weeks to evaluate treatment acceptability. We aimed to achieve a recruitment rate of ≥ 25% and retention rate of ≥ 80%, and have ≥ 50% of participants regain < 3% of their baseline weight.
Results supported the feasibility of recruiting (48%) and retaining participants (93% provided survey data; 100% had EMR weight). Pre-post changes in weight (73% with < 3% weight regain) and physical activity (Cohen's ds 0.38 to 0.52) supported the potential for the intervention to yield clinically significant results. Intervention adherence (mean 7.8 calls of 9 received) and positive feedback from interviews supported treatment acceptability.
The intervention should be evaluated in an adequately powered randomized controlled trial. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
本研究描述了一种行为干预措施的早期发展,以减少减重手术后的体重反弹。我们利用肥胖相关行为干预试验模型来指导干预措施的开发和评估。我们旨在建立招募、保留和忠实度监测程序;评估利用电子病历(EMR)中的体重作为结果的可行性;观察行为风险因素的改善;并评估治疗的可接受性。
该干预措施包括 4 次每周电话,讨论饮食、身体活动和营养补充剂依从性的行为改变策略,以及 5 次每两周电话,讨论体重维持的构建。9-15 个月前接受过减重手术的退伍军人(n=33)同意进行为期 16 周的预-后研究。通过电话在基线和 16 周时获得自我报告的结果。从 EMR 获得就诊前 6 个月和同意后的体重。在 16 周时进行定性访谈,以评估治疗的可接受性。我们的目标是达到≥25%的招募率和≥80%的保留率,并有≥50%的参与者体重恢复不超过基线体重的 3%。
结果支持招募(48%)和保留参与者(93%提供调查数据;100%有 EMR 体重)的可行性。体重(73%的人体重恢复不超过 3%)和身体活动(Cohen's ds 从 0.38 到 0.52)的预-后变化支持该干预措施有可能产生临床显著结果。干预的依从性(平均接受 9 次电话中的 7.8 次)和访谈的积极反馈支持治疗的可接受性。
应在一项充分有力的随机对照试验中评估该干预措施。(PsycInfo 数据库记录(c)2020 APA,保留所有权利)。