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一项旨在预防初级卫生保健中与妊娠相关的过度体重增加的对照试验的可行性。

Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care.

作者信息

Kinnunen Tarja I, Aittasalo Minna, Koponen Päivikki, Ojala Katriina, Mansikkamäki Kirsi, Weiderpass Elisabete, Fogelholm Mikael, Luoto Riitta

机构信息

UKK Institute for Health Promotion Research, Tampere, Finland.

出版信息

BMC Pregnancy Childbirth. 2008 Aug 11;8:37. doi: 10.1186/1471-2393-8-37.

Abstract

BACKGROUND

Excessive gestational weight gain and postpartum weight retention may predispose women to long-term overweight and other health problems. Intervention studies aiming at preventing excessive pregnancy-related weight gain are needed. The feasibility of implementing such a study protocol in primary health care setting was evaluated in this pilot study.

METHODS

A non-randomized controlled trial was conducted in three intervention and three control maternity and child health clinics in primary health care in Finland. Altogether, 132 pregnant and 92 postpartum women and 23 public health nurses (PHN) participated in the study. The intervention consisted of individual counselling on physical activity and diet at five routine visits to a PHN and of an option for supervised group exercise until 37 weeks' gestation or ten months postpartum. The control clinics continued their usual care. The components of the feasibility evaluation were 1) recruitment and participation, 2) completion of data collection, 3) realization of the intervention and 4) the public health nurses' experiences.

RESULTS

  1. The recruitment rate was slower than expected and the recruitment period had to be prolonged from the initially planned three months to six months. The average participation rate of eligible women at study enrollment was 77% and the drop-out rate 15%. 2) In total, 99% of the data on weight, physical activity and diet and 96% of the blood samples were obtained. 3) In the intervention clinics, 98% of the counselling sessions were realized, their contents and average durations were as intended, 87% of participants regularly completed the weekly records for physical activity and diet, and the average participation percentage in the group exercise sessions was 45%. 4) The PHNs regarded the extra training as a major advantage and the high additional workload as a disadvantage of the study.

CONCLUSION

The study protocol was mostly feasible to implement, which encourages conducting large trials in comparable settings.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN21512277.

摘要

背景

孕期体重过度增加和产后体重滞留可能使女性易患长期超重及其他健康问题。需要开展旨在预防与妊娠相关的体重过度增加的干预研究。本试点研究评估了在初级卫生保健机构实施此类研究方案的可行性。

方法

在芬兰初级卫生保健机构的三家干预性母婴保健诊所和三家对照性母婴保健诊所开展了一项非随机对照试验。共有132名孕妇、92名产后女性和23名公共卫生护士参与了该研究。干预措施包括在五次常规就诊时由公共卫生护士提供关于身体活动和饮食的个体化咨询,以及提供在妊娠37周或产后十个月前接受有监督的团体锻炼的选择。对照诊所继续其常规护理。可行性评估的内容包括:1)招募与参与情况;2)数据收集的完成情况;3)干预措施的实施情况;4)公共卫生护士的经验。

结果

1)招募速度比预期慢,招募期不得不从最初计划的三个月延长至六个月。符合条件的女性在研究入组时的平均参与率为77%,退出率为15%。2)总共获得了99%的体重、身体活动和饮食数据以及96%的血样。3)在干预性诊所,98%的咨询服务得以实施,其内容和平均时长符合预期,87%的参与者定期完成了每周的身体活动和饮食记录,团体锻炼课程的平均参与率为45%。4)公共卫生护士认为额外培训是该研究的一大优势,而额外工作量大是其劣势。

结论

该研究方案大多可行,这鼓励在类似环境中开展大型试验。

试验注册

当前受控试验ISRCTN21512277。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ef1/2526978/ac46e0ebb305/1471-2393-8-37-1.jpg

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