Eakin Elizabeth, Reeves Marina, Lawler Sheleigh, Graves Nick, Oldenburg Brian, Del Mar Chris, Wilke Ken, Winkler Elizabeth, Barnett Adrian
Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Queensland, Australia.
Am J Prev Med. 2009 Feb;36(2):142-9. doi: 10.1016/j.amepre.2008.09.042. Epub 2008 Dec 5.
The delivery of effective interventions to assist patients to improve their physical activity and dietary behaviors is a challenge in the busy primary care setting.
Cluster RCT with practices randomized to telephone counseling intervention or usual care. Data collection took place from February 2005 to November 2007, with analysis from December 2007 to April 2008.
SETTING/PARTICIPANTS: Four-hundred thirty-four adult patients with type 2 diabetes or hypertension (mean age=58.2 [SD=11.8]; 61% female; mean BMI=31.1 [SD=6.8]) from a disadvantaged community were recruited from ten primary care practices.
Twelve-month telephone counseling intervention.
Physical activity and dietary intake were assessed by self-report at baseline, 4, and 12 months.
At 12 months, patients in both groups increased moderate-to-vigorous physical activity by a mean of 78 minutes per week (SE=10). Significant intervention effects (telephone counseling minus usual care) were observed for: calories from total fat (decrease of 1.17%; p<0.007), energy from saturated fat (decrease of 0.97%; p<0.007), vegetable intake (increase of 0.71 servings; p<0.039), fruit intake (increase of 0.30 servings; p<0.001), and grams of fiber (increase of 2.23 g; p<0.001).
The study targeted a challenging primary care patient sample and, using a telephone-delivered intervention, demonstrated modest improvements in diet and in physical activity. Results suggest that telephone counseling is a feasible means of delivering lifestyle intervention to primary care patients with chronic conditions-patients whose need for ongoing support for lifestyle change is often beyond the capacity of primary healthcare practitioners.
在繁忙的基层医疗环境中，提供有效的干预措施以帮助患者改善身体活动和饮食行为是一项挑战。
整群随机对照试验，将医疗机构随机分为电话咨询干预组或常规护理组。数据收集于2005年2月至2007年11月进行，分析于2007年12月至2008年4月进行。
地点/参与者：从十个基层医疗诊所招募了434名来自弱势社区的成年2型糖尿病或高血压患者（平均年龄=58.2[标准差=11.8]；61%为女性；平均体重指数=31.1[标准差=6.8]）。
为期12个月的电话咨询干预。
在基线、4个月和12个月时通过自我报告评估身体活动和饮食摄入量。
在12个月时，两组患者的中度至剧烈身体活动平均每周增加78分钟（标准误=10）。观察到显著的干预效果（电话咨询减去常规护理）体现在：总脂肪热量（减少1.17%；p<0.007）、饱和脂肪能量（减少0.97%；p<0.007）、蔬菜摄入量（增加0.71份；p<0.039）、水果摄入量（增加0.30份；p<0.001）和纤维克数（增加2.23克；p<0.001）。
该研究针对具有挑战性的基层医疗患者样本，通过电话干预，在饮食和身体活动方面显示出适度改善。结果表明，电话咨询是为患有慢性病的基层医疗患者提供生活方式干预的可行手段——这类患者对生活方式改变持续支持的需求往往超出了基层医疗从业者的能力范围。
