Jeffery R W, Sherwood N E, Brelje K, Pronk N P, Boyle R, Boucher J L, Hase K
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
Int J Obes Relat Metab Disord. 2003 Dec;27(12):1584-92. doi: 10.1038/sj.ijo.0802473.
To describe methods, recruitment success, and 1-y results of a study evaluating the effectiveness of phone- and mail-based weight-loss interventions in a managed care setting.
Randomized clinical trial with three groups, that is, usual care, mail intervention, and phone intervention.
In total, 1801 overweight members of a managed-care organization (MCO).
Height, weight, medical status, and weight-loss history were measured at baseline. Participation in intervention activities was monitored for 12 months in the two active treatment groups. Self-reported weight was obtained at 6 and 12 months.
More individuals assigned to mail treatment started it (88%) than did those assigned to phone treatment (69%). However, program completion rates were higher in the phone (36%) than mail (7%) intervention. The mean weight losses were 1.93, 2.38, and 1.47 kg at 6 months in the mail, phone, and usual care groups, respectively. The differences between the phone and usual care groups were statistically significant. The mean weight losses at 12 months did not differ by treatment group (2.28 kg mail, 2.29 kg phone, and 1.92 kg usual care). Greater weight loss was seen in men, older participants, and those with no prior experience in a weight-loss program. Heavier participants and those who reported current treatment for depression lost less weight.
Although mail- and phone-based weight-loss programs can be delivered to large numbers of people in an MCO setting, additional work is needed to enhance their clinical efficacy as well as to assess their costs.
描述一项在管理式医疗环境中评估基于电话和邮件的减肥干预措施有效性的研究的方法、招募成功率及1年的研究结果。
三组随机临床试验，即常规护理、邮件干预和电话干预。
一家管理式医疗组织（MCO）的1801名超重成员。
在基线时测量身高、体重、健康状况和减肥史。在两个积极治疗组中对干预活动的参与情况进行为期12个月的监测。在6个月和12个月时获取自我报告的体重。
分配到邮件治疗组的个体开始治疗的比例（88%）高于分配到电话治疗组的个体（69%）。然而，电话干预组的项目完成率（36%）高于邮件干预组（7%）。在6个月时，邮件组、电话组和常规护理组的平均体重减轻分别为1.93千克、2.38千克和1.47千克。电话组和常规护理组之间的差异具有统计学意义。12个月时各治疗组的平均体重减轻无差异（邮件组2.28千克，电话组2.29千克，常规护理组1.92千克）。男性、年龄较大的参与者以及那些之前没有参加过减肥项目的人减重更多。体重较重的参与者以及那些报告目前正在接受抑郁症治疗的人减重较少。
尽管基于邮件和电话的减肥项目可以在MCO环境中提供给大量人群，但仍需要开展更多工作来提高其临床疗效并评估其成本。
