Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.
Am J Public Health. 2011 Oct;101(10):1914-21. doi: 10.2105/AJPH.2011.300151. Epub 2011 Aug 18.
We evaluated a theory-based lifestyle intervention targeting physical activity and dietary fat intake among African American women at high risk for cardiovascular disease.
The Heart Healthy and Ethnically Relevant Lifestyle trial (2005-2008) randomly assigned 266 low-income African American women aged 35 years and older who were patients of South Carolina community health care centers into comprehensive or standard care interventions. Comprehensive participants received standard care (stage-matched provider counseling and assisted goal setting) plus 12 months of telephone counseling and tailored newsletters. Primary outcomes were 6- and 12-month self-reported physical activity and dietary fat intake.
Comprehensive participants were more likely than were standard care participants to decrease total physical activity (odds ratio [OR] = 3.13; 95% confidence interval [CI] = 1.18, 8.25) and increase leisure-time physical activity (OR = 3.82; 95% CI = 1.41, 10.3) at 6 months (no 12-month differences). Mean reductions in Dietary Risk Assessment score occurred in both groups but were greater among comprehensive participants than among standard care participants (6 months, -8.50 vs -5.34; 12 months, -7.16 vs -3.37; P < .001).
The comprehensive intervention improved women's leisure-time physical activity and dietary fat intake, highlighting a replicable model to help primary care providers implement lifestyle counseling.
我们评估了一项针对有心血管疾病高危风险的非裔美国女性的基于理论的生活方式干预,该干预针对身体活动和膳食脂肪摄入。
“心脏健康和种族相关生活方式试验”(2005-2008 年)随机将 266 名年龄在 35 岁及以上的、收入较低的、南卡罗来纳社区卫生保健中心的非裔美国女性患者分为全面护理或标准护理干预组。全面护理组除了接受标准护理(与阶段匹配的提供者咨询和协助设定目标)外,还接受了 12 个月的电话咨询和量身定制的通讯。主要结局是 6 个月和 12 个月的自我报告身体活动和膳食脂肪摄入。
与标准护理组相比,全面护理组更有可能减少总身体活动(比值比[OR] = 3.13;95%置信区间[CI] = 1.18,8.25)和增加休闲时间身体活动(OR = 3.82;95% CI = 1.41,10.3)在 6 个月时(12 个月时无差异)。两组的膳食风险评估得分都有所降低,但全面护理组的降幅大于标准护理组(6 个月时,-8.50 对-5.34;12 个月时,-7.16 对-3.37;P <.001)。
全面干预改善了女性的休闲时间身体活动和膳食脂肪摄入,突出了一种可复制的模式,以帮助初级保健提供者实施生活方式咨询。