PDF(Pubmed)
Abstract：
Studies have consistently shown that African American individuals lose less weight in response to behavioral interventions, but the mechanisms leading to this result have been understudied.
Data were derived from the PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) study, which was a cluster-randomized, two-arm trial conducted in primary care clinics. In the PROPEL trial, African American individuals lost less weight compared with patients who belonged to other racial groups after 24 months. In the current study, counterfactual mediation analyses among 445 patients in the intervention arm of PROPEL were used to determine which variables mediated the relationship between race and weight loss. The mediators included treatment engagement, psychosocial, and lifestyle factors.
At 6 months, daily weighing mediated 33% (p = 0.008) of the racial differences in weight loss. At 24 months, session attendance and daily weighing mediated 35% (p = 0.027) and 66% (p = 0.005) of the racial differences in weight loss, respectively. None of the psychosocial or lifestyle variables mediated the race-weight loss association.
Strategies specifically targeting engagement, such as improving session attendance and self-weighing behaviors, among African American individuals are needed to support more equitable weight losses over extended time periods.
Data were derived from the PROmoting Successful Weight Loss in Primary CarE in Louisiana (PROPEL) study, which was a cluster-randomized, two-arm trial conducted in primary care clinics. In the PROPEL trial, African American individuals lost less weight compared with patients who belonged to other racial groups after 24 months. In the current study, counterfactual mediation analyses among 445 patients in the intervention arm of PROPEL were used to determine which variables mediated the relationship between race and weight loss. The mediators included treatment engagement, psychosocial, and lifestyle factors.
At 6 months, daily weighing mediated 33% (p = 0.008) of the racial differences in weight loss. At 24 months, session attendance and daily weighing mediated 35% (p = 0.027) and 66% (p = 0.005) of the racial differences in weight loss, respectively. None of the psychosocial or lifestyle variables mediated the race-weight loss association.
Strategies specifically targeting engagement, such as improving session attendance and self-weighing behaviors, among African American individuals are needed to support more equitable weight losses over extended time periods.
摘要：
目的：研究一致表明，非洲裔美国人对行为干预的反应体重减轻，但是导致这一结果的机制尚未得到充分研究。
方法：数据来自路易斯安那州初级CarE（PROPEL）研究的成功减肥，这是一个集群随机的，在初级保健诊所进行的双臂试验.在PROPEL审判中,24个月后，与属于其他种族的患者相比，非洲裔美国人的体重减轻更少。在目前的研究中,我们对PROPEL干预组的445例患者进行了反事实中介分析,以确定哪些变量介导了种族与体重减轻之间的关系.调解员包括治疗参与，社会心理,和生活方式因素。
结果：在6个月时，每日体重介导了33%(p=0.008)的体重减轻种族差异.24个月时,会议出勤率和每日体重介导了35%(p=0.027)和66%(p=0.005)的减肥种族差异，分别。社会心理或生活方式变量均未介导种族体重减轻的关联。
结论：专门针对参与的策略，例如改善会议出勤率和自我权衡行为，在非洲裔美国人中，需要在延长的时间段内支持更公平的减肥。
方法：数据来自路易斯安那州初级CarE（PROPEL）研究的成功减肥，这是一个集群随机的，在初级保健诊所进行的双臂试验.在PROPEL审判中,24个月后，与属于其他种族的患者相比，非洲裔美国人的体重减轻更少。在目前的研究中,我们对PROPEL干预组的445例患者进行了反事实中介分析,以确定哪些变量介导了种族与体重减轻之间的关系.调解员包括治疗参与，社会心理,和生活方式因素。
结果：在6个月时，每日体重介导了33%(p=0.008)的体重减轻种族差异.24个月时,会议出勤率和每日体重介导了35%(p=0.027)和66%(p=0.005)的减肥种族差异，分别。社会心理或生活方式变量均未介导种族体重减轻的关联。
结论：专门针对参与的策略，例如改善会议出勤率和自我权衡行为，在非洲裔美国人中，需要在延长的时间段内支持更公平的减肥。
