University of Wisconsin-Madison School of Medicine & Public Health, Department of Surgery, 600 Highland Ave, K6/100 CSC, Madison, WI 53792-1690, USA; William S Middleton Memorial Veterans Hospital, 2500 Overlook Terrace (151), Madison, WI 53705, USA.
Duke University School of Nursing, 307 Trent Dr., 1055 Clipp, Durham, NC 27710, USA.
Contemp Clin Trials. 2020 Sep;96:106092. doi: 10.1016/j.cct.2020.106092. Epub 2020 Aug 1.
Behavioral interventions produce clinically significant weight reduction, with many participants regaining weight subsequently. Most interventions focus on an individual, but dietary and physical activity behaviors occur with, or are influenced by, domestic partners. According to interdependence theory, couples who approach behavior change as a problem to be tackled together versus independently are more likely to utilize communal coping processes to promote behavior change. We utilized interdependence theory to develop a partner-assisted intervention to increase long-term weight loss.
Community-dwelling individuals (index participants) cohabitating with a partner with 1) overweight and at least one obesity-related comorbidity or 2) obesity are randomized to participate in a standard weight management program alone or with their partner. The weight management program involves biweekly, in-person, group sessions focusing on weight loss for six months, followed by three group sessions and nine telephone calls focusing on weight loss maintenance for twelve months. In the partner-assisted arm, partners participate in half of the group sessions and telephone calls. Couples receive training in principles of cognitive behavioral therapy for couples, including sharing thoughts and feelings and joint problem solving, to increase communal coping. The primary outcome is participant weight loss at 24 months, with caloric intake and moderate-intensity physical activity as secondary outcomes. Partner weight and caloric intake will also be analyzed. Mediation analyses will examine the role of interdependence variables and social support.
This trial will provide knowledge about effective ways to promote long-term weight loss and the role of interdependence constructs in weight loss. Clinical trials identifier: NCT03801174.
行为干预可显著减轻体重，且许多参与者随后体重会反弹。大多数干预措施都以个体为中心，但饮食和身体活动行为会受到伴侣的影响，或者是伴侣促成的。根据相互依存理论，夫妻共同而非独立地将行为改变视为一个共同需要解决的问题，他们更有可能利用公共应对策略来促进行为改变。我们运用相互依存理论制定了一项伴侣辅助干预措施，以增加长期减肥效果。
与超重且至少有 1 种肥胖相关合并症的伴侣共同居住的社区居民（索引参与者）随机分为两组，一组单独参加标准体重管理项目，另一组与伴侣一起参加。体重管理项目包括每两周进行一次的现场小组会议，持续六个月，重点是减肥，然后进行三次小组会议和九次电话会议，重点是减肥维持十二个月。在伴侣辅助组中，伴侣参加一半的小组会议和电话会议。夫妻双方都接受关于夫妻认知行为疗法原则的培训，包括分享想法和感受以及共同解决问题，以增强公共应对能力。主要结果是参与者在 24 个月时的体重减轻情况，次要结果包括卡路里摄入量和中等强度的身体活动。还将分析伴侣的体重和卡路里摄入量。中介分析将检验相互依存变量和社会支持的作用。
该试验将提供关于有效促进长期减肥的方法以及相互依存结构在减肥中的作用的知识。临床试验标识符：NCT03801174。
