College of Nursing, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Nurs Res. 2010 Sep-Oct;59(5):311-21. doi: 10.1097/NNR.0b013e3181ed6695.
In the Wellness for Women Project, a randomized-by-site 1-year controlled clinical trial, the efficacy of generic newsletters and newsletters tailored on Health Promotion Model behavior-specific cognitions, eating behavior, and activity behavior were compared among 225 women aged 50 to 69 years.
The purpose of this study was to compare the maintenance of change in healthy eating and physical activity over the 12 months following the tailored versus generic mailed newsletter intervention.
Outcomes at 18 and 24 months included behavioral markers and biomarkers of physical activity and eating. Data were analyzed using the multivariate approach to repeated measures analysis of variance and generalized estimating equations (alpha <.05).
At 18 months, the tailored group maintained levels of all eating and activity behaviors, whereas the generic group maintained levels of fruit and vegetable servings, a moderate or greater activity, stretching exercise, lower body strength and flexibility but increased saturated fat intake and declined in weekly strength exercise and cardiorespiratory fitness. At 24 months, both groups maintained or returned to 12-month levels of all eating behaviors,moderate or greater activity, stretching exercise, and flexibility but declined in cardiorespiratory fitness; the tailored group maintained levels of strength exercise and lower body strength, whereas the generic group decreased in both. A greater proportion of women who received tailored newsletters continued to achieve most Healthy People 2010 criteria for eating and activity.
Mailed tailored print newsletters were more efficacious than generic newsletters in facilitating maintenance of change in eating and activity for 6 months postintervention. Both tailored and generic newsletters facilitated the maintenance of change in eating behaviors and in moderate or greater physical activity and stretching exercise, whereas tailored newsletters were more efficacious in maintaining change in strength exercise for 12 months postintervention.
在“妇女健康计划”（Wellness for Women Project）中，我们开展了一项为期 1 年的随机分组对照临床试验，对 225 名年龄在 50 至 69 岁的女性进行了通用新闻稿和基于健康促进模式行为特定认知、饮食行为和活动行为的定制新闻稿的效果比较。
本研究旨在比较经过定制和通用邮寄新闻稿干预后 12 个月内健康饮食和身体活动的维持变化情况。
18 个月和 24 个月的结果包括行为标志物和身体活动及饮食的生物标志物。数据分析采用重复测量方差分析和广义估计方程的多变量方法（alpha<.05）。
在 18 个月时，定制组维持了所有饮食和活动行为的水平，而通用组则维持了水果和蔬菜摄入量、中等或更大强度的活动、伸展运动、下半身力量和灵活性，但增加了饱和脂肪的摄入量，每周力量锻炼和心肺健康的频率下降。在 24 个月时，两组均维持或恢复到 12 个月时的所有饮食行为、中等或更大强度的活动、伸展运动和灵活性水平，但心肺健康下降；定制组维持了力量锻炼和下半身力量的水平，而通用组则两者均下降。接受定制新闻稿的女性中，有更大比例继续达到《2010 年健康人》饮食和活动的多数标准。
邮寄定制印刷新闻稿在促进干预后 6 个月内的饮食和活动维持变化方面比通用新闻稿更有效。定制和通用新闻稿都有助于维持饮食行为和中等或更大强度的身体活动和伸展运动的变化，而定制新闻稿在干预后 12 个月内更有效地维持力量锻炼的变化。
