Predictors of racial differences in weight loss: the PROPEL trial.

Autor: Newton RL Jr; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Zhang D; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Johnson WD; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Martin CK; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Apolzan JW; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Denstel KD; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Brantley PJ; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA., Davis TC; Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA., Arnold C; Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA., Sarpong DF; Office of Health Equity Research, Yale University School of Medicine, New Haven, Connecticut, USA., Price-Haywood EG; Ochsner Xavier Institute for Health Equity and Research, Ochsner Health, New Orleans, Louisiana, USA., Lavie CJ; John Ochsner Heart and Vascular Institute, Ochsner Clinical School, New Orleans, Louisiana, USA., Thethi TK; AdventHealth Translational Research Institute, Orlando, Florida, USA., Katzmarzyk PT; Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Jazyk: angličtina
Zdroj: Obesity (Silver Spring, Md.) [Obesity (Silver Spring)] 2024 Mar; Vol. 32 (3), pp. 476-485. Date of Electronic Publication: 2023 Dec 06.
DOI: 10.1002/oby.23936
Abstrakt: Objective: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
(© 2023 The Obesity Society.)
Databáze: MEDLINE
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