Project Health: Enhancing Effectiveness of a Dissonance-Based Obesity Prevention Program
| Status: | Recruiting |
|---|---|
| Conditions: | Obesity Weight Loss, Obesity Weight Loss |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 17 - 20 |
| Updated: | 10/27/2018 |
| Start Date: | October 8, 2018 |
| End Date: | July 31, 2023 |
| Contact: | Eric M Stice, Ph.D. |
| Email: | estice@ori.org |
| Phone: | 541-484-2123 |
Enhancing Effectiveness of a Dissonance-Based Obesity Prevention Program
This project seeks to improve the effectiveness of a novel dissonance-based obesity
prevention program that has reduced future BMI gain and overweight/obesity onset by (a)
experimentally testing whether implementing it in single- versus mixed-sex groups, which
should increase dissonance-induction that contributes to weight gain prevention effects, and
(b) experimentally testing whether adding food response and attention training, which
theoretically reduces valuation of and attention for high-calorie foods, increases weight
gain prevention effects. This randomized trial would be the first to experimentally
manipulate these two factors in an effort to produce superior weight gain prevention effects.
A brief effective obesity prevention program that can be easily, inexpensively, and broadly
implemented to late adolescents at risk for excess weight gain, as has been the case with
another dissonance-based prevention program, could markedly reduce the prevalence of obesity
and associated morbidity and mortality.
prevention program that has reduced future BMI gain and overweight/obesity onset by (a)
experimentally testing whether implementing it in single- versus mixed-sex groups, which
should increase dissonance-induction that contributes to weight gain prevention effects, and
(b) experimentally testing whether adding food response and attention training, which
theoretically reduces valuation of and attention for high-calorie foods, increases weight
gain prevention effects. This randomized trial would be the first to experimentally
manipulate these two factors in an effort to produce superior weight gain prevention effects.
A brief effective obesity prevention program that can be easily, inexpensively, and broadly
implemented to late adolescents at risk for excess weight gain, as has been the case with
another dissonance-based prevention program, could markedly reduce the prevalence of obesity
and associated morbidity and mortality.
Prevention is key for combating obesity, but few programs have prevented future increases in
BMI and onset of overweight/obesity, particularly during late adolescence when youth often
assume responsibility for dietary intake and exercise choices. One exception is a brief 6-hr
dissonance-based program (Project Health) wherein participants make small lasting incremental
lifestyle changes to dietary intake and exercise to reach energy balance, and discuss costs
of obesity, an unhealthy diet, and sedentary behavior, and benefits of leanness, a healthy
diet, and exercise, which prompts them to align their attitudes with their publically
displayed behavior. These activities promote the internalization of health goals and
executive control over lifestyle behaviors. Late adolescents randomized to Project Health
showed fewer increases in BMI and a 41% and 43% reduction in overweight/obesity onset over
2-yr follow-up compared to a version of the program lacking dissonance induction activities
and an obesity education condition. Project Health appears to be the first program to produce
these key obesity prevention effects relative to an alternative intervention, but it is
critical to increase effects. A dissonance-based prevention program was more effective when
implemented in single- versus mixed-sex groups, theoretically, because it promoted greater
participation in dissonance-inducing discussions. Aim 1a is to test whether the weight gain
prevention effects will be larger when Project Health is implemented in single-sex groups; we
will randomize 450 17-20-year-olds to complete Project Health in female, male, or mixed-sex
groups, assessing outcomes at pretest, posttest, and 6, 12, 24, and 36-month follow-ups. Aim
1b is to test whether greater participation in dissonance-inducing discussions and group
cohesion mediate the effect of condition on any superior weight gain prevention effects.
Adolescents who show greater fMRI-assessed reward and attention region responsivity to food
images exhibit elevated future weight gain, implying that reducing this responsivity may
reduce future weight gain. In a pilot trial, late adolescents who completed go/nogo,
stop-signal, and respond-signal computer training in which they repeatedly inhibit responses
to high-calorie foods and respond to low-calorie foods, and dot-probe and visual-search
computer tasks that train attention away from high-calorie foods and to low-calorie foods,
showed a greater reduction in reward and attention region responsivity to, palatability
rating of, and willingness to pay for, high-calorie foods, suggesting reduced valuation and
attentional bias, as well as greater fat loss over 1-yr follow-up versus controls who
completed the training with non-food images. Aim 2a is to test whether adding food response
and attention training to Project Health will produce larger weight gain prevention effects.
Participants in the 3 conditions will be randomized to complete response and attention
training for 25-mins after each of the 6-sessions with either food or non-food images. Aim 2b
is to test whether reduced palatability ratings of, willingness to pay, and attentional bias
for high-calorie foods mediate the effect of training condition on any superior weight gain
prevention effects.
BMI and onset of overweight/obesity, particularly during late adolescence when youth often
assume responsibility for dietary intake and exercise choices. One exception is a brief 6-hr
dissonance-based program (Project Health) wherein participants make small lasting incremental
lifestyle changes to dietary intake and exercise to reach energy balance, and discuss costs
of obesity, an unhealthy diet, and sedentary behavior, and benefits of leanness, a healthy
diet, and exercise, which prompts them to align their attitudes with their publically
displayed behavior. These activities promote the internalization of health goals and
executive control over lifestyle behaviors. Late adolescents randomized to Project Health
showed fewer increases in BMI and a 41% and 43% reduction in overweight/obesity onset over
2-yr follow-up compared to a version of the program lacking dissonance induction activities
and an obesity education condition. Project Health appears to be the first program to produce
these key obesity prevention effects relative to an alternative intervention, but it is
critical to increase effects. A dissonance-based prevention program was more effective when
implemented in single- versus mixed-sex groups, theoretically, because it promoted greater
participation in dissonance-inducing discussions. Aim 1a is to test whether the weight gain
prevention effects will be larger when Project Health is implemented in single-sex groups; we
will randomize 450 17-20-year-olds to complete Project Health in female, male, or mixed-sex
groups, assessing outcomes at pretest, posttest, and 6, 12, 24, and 36-month follow-ups. Aim
1b is to test whether greater participation in dissonance-inducing discussions and group
cohesion mediate the effect of condition on any superior weight gain prevention effects.
Adolescents who show greater fMRI-assessed reward and attention region responsivity to food
images exhibit elevated future weight gain, implying that reducing this responsivity may
reduce future weight gain. In a pilot trial, late adolescents who completed go/nogo,
stop-signal, and respond-signal computer training in which they repeatedly inhibit responses
to high-calorie foods and respond to low-calorie foods, and dot-probe and visual-search
computer tasks that train attention away from high-calorie foods and to low-calorie foods,
showed a greater reduction in reward and attention region responsivity to, palatability
rating of, and willingness to pay for, high-calorie foods, suggesting reduced valuation and
attentional bias, as well as greater fat loss over 1-yr follow-up versus controls who
completed the training with non-food images. Aim 2a is to test whether adding food response
and attention training to Project Health will produce larger weight gain prevention effects.
Participants in the 3 conditions will be randomized to complete response and attention
training for 25-mins after each of the 6-sessions with either food or non-food images. Aim 2b
is to test whether reduced palatability ratings of, willingness to pay, and attentional bias
for high-calorie foods mediate the effect of training condition on any superior weight gain
prevention effects.
Inclusion Criteria:
- Current at least moderate weight concerns (response of moderate, severe or extreme to
the presence of weight concerns question)
- BMI between 20 and 30
Exclusion Criteria:
- Current diagnosis of anorexia nervosa, bulimia nervosa, or binge eating disorder
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