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群体动机干预在初级医疗卫生保健领域超重/肥胖患者心血管疾病一级预防中的应用。

Group motivational intervention in overweight/obese patients in primary prevention of cardiovascular disease in the primary healthcare area.

机构信息

Medicina, Area Básica Salud Florida Sud, Parc dels Ocellets, L'Hospitalet del Llobregat, Barcelona, Spain.

出版信息

BMC Fam Pract. 2010 Mar 18;11:23. doi: 10.1186/1471-2296-11-23.

Abstract

BACKGROUND

The global mortality caused by cardiovascular disease increases with weight. The Framingham study showed that obesity is a cardiovascular risk factor independent of other risks such as type 2 diabetes mellitus, dyslipidemia and smoking. Moreover, the main problem in the management of weight-loss is its maintenance, if it is achieved. We have designed a study to determine whether a group motivational intervention, together with current clinical practice, is more efficient than the latter alone in the treatment of overweight and obesity, for initial weight loss and essentially to achieve maintenance of the weight achieved; and, secondly, to know if this intervention is more effective for reducing cardiovascular risk factors associated with overweight and obesity.

METHODS

This 26-month follow up multi-centre trial, will include 1200 overweight/obese patients. Random assignment of the intervention by Basic Health Areas (BHA): two geographically separate groups have been created, one of which receives group motivational intervention (group intervention), delivered by a nurse trained by an expert phsychologist, in 32 group sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard program of diet, exercise, and the other (control group), receiving the usual follow up, with regular visits every 3 months.

DISCUSSION

By addressing currently unanswered questions regarding the maintenance in weight loss in obesity/overweight, upon the expected completion of participant follow-up in 2012, the IMOAP trial should document, for the first time, the benefits of a motivational intervention as a treatment tool of weight loss in a primary care setting.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01006213.

摘要

背景

心血管疾病导致的全球死亡率随体重增加而上升。弗雷明汉研究表明肥胖是一种独立于其他风险因素(如 2 型糖尿病、血脂异常和吸烟)的心血管危险因素。此外,体重管理的主要问题在于保持减肥效果,如果能够实现减肥的话。我们设计了一项研究,旨在确定群体动机干预与当前临床实践相结合是否比后者更有效地治疗超重和肥胖,以实现初始体重减轻,并主要实现所减轻体重的维持;其次,了解这种干预是否更有效地降低与超重和肥胖相关的心血管危险因素。

方法

这是一项为期 26 个月的多中心随访试验,将纳入 1200 名超重/肥胖患者。通过基本卫生区(BHA)随机分配干预措施:创建了两个地理位置分开的组,一组接受群体动机干预(群体干预),由经过专家心理学家培训的护士在 32 次小组会议中提供,每两周 1 次,13 至 32 次,每月 1 次,在他们的标准饮食、运动计划之上;另一组(对照组)接受常规随访,每 3 个月定期就诊。

讨论

通过解决肥胖/超重体重减轻维持方面的未回答问题,IMOAP 试验预计在 2012 年完成参与者随访后,将首次记录动机干预作为初级保健环境中体重减轻治疗工具的益处。

试验注册

ClinicalTrials.gov 标识符:NCT01006213。

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