Stanford Healthy Heart Study
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 4/3/2019 |
| Start Date: | March 4, 2017 |
| End Date: | July 2020 |
Escalating Proportion of Weight-Loss Maintainers Via Modules Prior to Weight Loss
People with elevated blood pressure are at higher risk of having a heart attack or stroke
than people with lower blood pressure. Losing a modest amount of weight—such as 15 or 20
pounds—can reduce the risk of having a heart attack or stroke. However, it can often be a
struggle to maintain weight loss over time.
This study examines whether two behavioral weight-management programs can help people
maintain weight loss over time. In this study, 346 adults will be randomly assigned (like
flipping a coin) to one of the 12-month programs and followed for 36 months (i.e., 3 years)
to see how their body weight may change.
than people with lower blood pressure. Losing a modest amount of weight—such as 15 or 20
pounds—can reduce the risk of having a heart attack or stroke. However, it can often be a
struggle to maintain weight loss over time.
This study examines whether two behavioral weight-management programs can help people
maintain weight loss over time. In this study, 346 adults will be randomly assigned (like
flipping a coin) to one of the 12-month programs and followed for 36 months (i.e., 3 years)
to see how their body weight may change.
This randomized trial will test the efficacy and cost-effectiveness of novel modules
administered prior to weight loss that are explicitly designed to enhance enjoyment of
healthy lifestyle behaviors independent of any longer-term health effects, and thus escalate
the proportion of individuals sustaining ≥7% weight loss over the long-term.
Overweight/obese individuals with elevated blood pressure will be randomized to one of two
12-month weight-management interventions (Fun First or Weight Watchers) and followed for 36
months. For Aim 1 (Primary outcome), we will test whether Fun First is more efficacious than
Weight Watchers using a mediator-intervention interaction model with sufficient a priori
statistical power for the interaction effect as well as the intervention and mediator main
effects. The posited mediator assesses participants' change in enjoyment for four key healthy
lifestyle behaviors (healthy eating, physical activity, weighing and self-nurturing) via
online survey from 0-2 months. The primary outcome is the proportion of participants who lose
a clinically significant amount of initial body weight and maintain it during the trial
(i.e., lose >=7% of their initial body weight from 0-12 months and gain <=5 lbs from 12-36
months), assessed on clinic scales during in-person visits at the research clinic. Secondary
outcomes include the proportion of individuals sustaining ≥7% weight loss over the trial
assessed by digital cellular scales in participants' homes and participants' change in
systolic blood pressure over the trial assessed at the research clinic.
For Aim 2 (Other pre-specified outcomes), we will test whether Fun First is more cost
effective than Weight Watchers using both individual-level trial data and systems science
modeling for long-term, population-level hypertension and cardiovascular disease incidence,
health care and disability costs, and quality-adjusted life-years over the life course.
administered prior to weight loss that are explicitly designed to enhance enjoyment of
healthy lifestyle behaviors independent of any longer-term health effects, and thus escalate
the proportion of individuals sustaining ≥7% weight loss over the long-term.
Overweight/obese individuals with elevated blood pressure will be randomized to one of two
12-month weight-management interventions (Fun First or Weight Watchers) and followed for 36
months. For Aim 1 (Primary outcome), we will test whether Fun First is more efficacious than
Weight Watchers using a mediator-intervention interaction model with sufficient a priori
statistical power for the interaction effect as well as the intervention and mediator main
effects. The posited mediator assesses participants' change in enjoyment for four key healthy
lifestyle behaviors (healthy eating, physical activity, weighing and self-nurturing) via
online survey from 0-2 months. The primary outcome is the proportion of participants who lose
a clinically significant amount of initial body weight and maintain it during the trial
(i.e., lose >=7% of their initial body weight from 0-12 months and gain <=5 lbs from 12-36
months), assessed on clinic scales during in-person visits at the research clinic. Secondary
outcomes include the proportion of individuals sustaining ≥7% weight loss over the trial
assessed by digital cellular scales in participants' homes and participants' change in
systolic blood pressure over the trial assessed at the research clinic.
For Aim 2 (Other pre-specified outcomes), we will test whether Fun First is more cost
effective than Weight Watchers using both individual-level trial data and systems science
modeling for long-term, population-level hypertension and cardiovascular disease incidence,
health care and disability costs, and quality-adjusted life-years over the life course.
Inclusion Criteria (BMI):
- 27 <= BMI < 45 kg/m2
Inclusion Criteria (Elevated Blood Pressure):
- Systolic blood pressure between 120-159 mmHg OR diastolic blood pressure between 80-99
mmHg. Can be on >=1 antihypertensive medications if on stable dose for past 3 months
- Systolic blood pressure <120 mmHg OR diastolic blood pressure <80 mmHg, if on stable
dose of >=1 antihypertensive medications for past 3 months
Exclusion Criteria (Blood Pressure):
- Elevated blood pressure: Systolic blood pressure >=160 mmHg OR diastolic blood
pressure >=100 mmHg
Exclusion Criteria (Underlying medical conditions/diseases):
- Have had a heart attack, stroke, coronary heart disease, congestive heart failure, or
angina
- Have had coronary artery bypass surgery or cardiac catheterization such as
percutaneous transluminal coronary angioplasty (PTCA), cath or stent placement
- Have diabetes
- Have medical contraindications to regular, unsupervised physical activity
- Have moderate to severe asthma, or chronic obstructive pulmonary disorder (also called
emphysema or chronic bronchitis)
- Had cancer in the past 5 years (except non-melanoma skin cancer)
- Currently under medical care for digestive issues, gastrointestinal distress,
abdominal pain, or diarrhea
- Had an organ transplant
Exclusion Criteria (Medications):
- Not stable on medications over the past 3 months (e.g., cholesterol, thyroid,
estrogen-hormone, psychiatric)
- Currently taking prescription pain medications (e.g., Vicodin, Oxycodone)
Exclusion Criteria (Weight and diet related):
- Have binge eating disorder or bulimic compensatory symptoms
- Currently taking medication designed to lose weight
- Have undergone weight-loss surgery (e.g., gastric bypass, lap band)
- Have lost >10 pounds in the past 6 months
- Currently in a weight-loss program (e.g., Jenny Craig)
- Currently participating in any support groups that focus on weight or eating habits
(e.g., Overeaters Anonymous)
- Currently on a special diet for a serious health condition
- Not willing to discontinue a special diet (e.g., Atkins)
Exclusion Criteria (Behavioral related):
- Planning to move in the next year
- Currently pregnant or planning to be within the next year
- Participating in another research study
- No regular access to a mobile phone and Internet
- Not able to speak, read, or understand English for informed consent
- Not willing to be randomized
- Did not complete eligibility process successfully or in a timely manner
- Staff discretion or judgement
- Live within Bay Area (e.g., ~1-hour commute from Stanford research center)
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