Obesity Clinical Trial
Official title:
Intervention for Sustainable Weight Loss in Military Families
U.S. Army Medical Research & Materiel Command Telemedicine and Advanced Technology Research Center (TATRC) is sponsoring the HF2 (Healthy Families, Healthy Forces) Study. This is a randomized trial comparing two different interventions for sustainable weight loss. Specifically, the investigators will compare a "current best practice (CBP)" intervention that includes standard dietary advice with a new, "Healthy Weight for Living (HWL)" intervention that includes recommendations to eat a diet rich in protein, dietary fiber, low glycemic index carbohydrates and low calorie foods. The objective of this study is to compare the CBP and HWL interventions when delivered to adult dependents of active duty (AD) military personnel and measure weight loss effects in both the adult dependents and the AD military personnel they live with.
This is a randomized trial comparing two different interventions for sustainable weight loss.
Specifically researchers will compare a current best practice (CBP) intervention that
includes standard dietary advice with a new Healthy Weight for Living (HWL) intervention that
includes recommendations to eat a diet rich in protein, dietary fiber and low glycemic index
carbohydrates. The population will be adult dependents of Active Duty (AD) military personnel
or retired military personnel (direct intervention participants) and the AD or retired
military personnel they live with (indirect intervention participants). The primary outcome
will be weight change from baseline to 1 year in the adult dependents. The objective of this
study is to compare the CBP and HWL interventions when delivered to adult dependents of AD or
retired military personnel and measure weight loss effects in both the adult dependents and
the AD or retired military personnel they live with. The working hypothesis is that that the
HWL intervention will result in significantly greater weight loss over 1 year than the CBP
intervention in an intent-to-treat analysis in adult dependents, and that the greater weight
loss in HWL will be associated with greater management of hunger and greater adherence to the
goal of reducing energy intake. Weight change up until the 18-24 month period will be
measured as a secondary outcome in a cohort of participants who will reach the 18-24 month
milestone in the study on or prior to December, 2018. A per protocol analysis will also be
applied for comparison of the two weight loss arms. (In addition, weight change will be
measured in the participants' AD or retired military personnel partner to test the hypothesis
that there is a ripple effect of benefits from the interventions associated with effects in
the primary recipients.) The original study plan was to examine weight change over 2 years
but due to slower recruiting than anticipated the hypotheses were revised to allow for 1 year
to be the primary outcome, with secondary outcomes in the subgroup followed until 18-24
months.
The researchers plan to test our central hypothesis and accomplish the study objectives with
the following technical objectives:
1. Conduct a randomized trial comparing the HWL intervention to the CBP intervention over 1
year in adult dependents of AD or retired military personnel. The primary outcome will
be weight change from baseline to 1 year. The working hypothesis is that randomization
to the HWL intervention will result in significantly greater weight loss over 1 year
than randomization to the CBP intervention, and that greater weight loss in the HWL
intervention will be associated with greater adherence to the goals of reducing energy
intake and hunger.
2. Compare the change in weight loss of participants in the HWL intervention to the CBP
intervention over the 18-24 month timepoints in the subgroup of participants who will
reach the 18-24 month milestone on or prior to December, 2018. The working hypothesis is
that randomization to the HWL intervention will result in significantly improved weight
loss retention compared to randomization to the CBP intervention.
3. Examine the effects of the interventions delivered to adult dependents of AD or retired
military personnel on the weight of AD or retired military personnel themselves. The
working hypothesis, based on preliminary data, is that there will be a "ripple" effect
of program benefits from intervention participants to the AD or retired military
personnel they live with; specifically, overweight and obese AD or retired military
personnel will lose more weight if their partner is randomized to the HWL intervention
compared to the CBP intervention, because the weight loss of AD or retired military
personnel indirectly exposed to the intervention will be proportional to the weight loss
of their adult dependent who is directly exposed.
4. Compare the effects of the two interventions on changes in cardiometabolic risk factors.
The working hypothesis is that there will be significantly greater improvements between
baseline and 1 year in key cardiometabolic risk factors in adult dependents enrolled in
the HWL intervention compared to the CBP intervention, and differences between groups
will be predicted by differences in weight loss. For a select subgroup of participants
who reach the 18-24 month timepoint on or prior to December 2018, the working hypothesis
is that there will be significantly greater improvements in between baseline and 2 years
in key cardiometabolic risk factors in adult dependents enrolled in the HWL compared to
the CBP intervention.
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