在老年人中心进行的一项基于人群的随机对照试验：基层健康促进员翻译的减肥干预措施。
Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial.
机构信息
Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, USA.
出版信息
Am J Prev Med. 2011 Oct;41(4):385-91. doi: 10.1016/j.amepre.2011.06.041.
BACKGROUND
Older adults have high obesity rates and respond well to evidence-based weight-loss programs, such as the Diabetes Prevention Program (DPP) Lifestyle intervention. The goal of this study was to determine whether a translation of the DPP Lifestyle program delivered by lay health educators and conducted in senior centers is effective in promoting weight loss among older adults.
DESIGN
An RCT with older adults nested within senior centers. Senior centers identified lay health educators to receive training and deliver the intervention program at the senior center. Senior centers were randomized to DPP Lifestyle program or an attention control intervention (cognitive training).
SETTING/PARTICIPANTS: Senior centers (N=15) located throughout Arkansas. Participants (N=228) were obese (BMI=34.5±4.9) older (aged 71.2±6.6 years) adults able to engage in moderate exercise. Follow-up data were collected at 4 months on 93% of the original cohort between February 2009 and July 2010.
INTERVENTIONS
A 12-session translation of the Diabetes Prevention Program Lifestyle behavioral weight-control program delivered in group sessions by trained lay health educators.
MAIN OUTCOME MEASURES
Body weight was assessed by digital scale. Percentage weight loss from baseline and proportion achieving ≥5% and ≥7% weight loss were examined. Analyses were completed in March 2011.
RESULTS
Participants attending senior centers randomized to Lifestyle lost a significantly greater percentage of baseline weight (3.8%, 95% CI=2.9%, 4.6%) than those in the control senior centers (0.2%, 95% CI= -0.6%, -0.9%) after adjusting for baseline BMI and gender (p<0.001). Among participants attending senior centers offering the Lifestyle program, 38% lost ≥5% of baseline weight compared with 5% in the control arm (p<0.001). Similarly, significantly more participants (24%) in Lifestyle senior centers lost ≥7% than did control participants (3%, p=0.001).
CONCLUSIONS
A behavioral lifestyle weight-loss intervention delivered by a lay health educator offers a promising vehicle for translation of evidence-based obesity treatment programs in underserved areas.
TRIAL REGISTRATION
This study is registered at Clinicaltrials.govNCT01377506.
背景
老年人肥胖率较高，对基于证据的减肥计划（如糖尿病预防计划（DPP）生活方式干预）反应良好。本研究的目的是确定由非专业健康教育者翻译并在老年人中心开展的 DPP 生活方式项目是否能有效促进老年人减肥。
设计
一项在老年人中心内嵌套的 RCT。老年人中心确定了非专业健康教育者，接受培训并在老年人中心提供干预计划。老年人中心被随机分配到 DPP 生活方式项目或注意力控制干预（认知训练）。
地点/参与者：阿肯色州各地的老年人中心（N=15）。参与者（N=228）为肥胖（BMI=34.5±4.9）的老年人（年龄 71.2±6.6 岁），能够进行适度运动。2009 年 2 月至 2010 年 7 月间，对最初队列中的 93%进行了为期 4 个月的随访，收集了 93%的数据。
干预措施
对糖尿病预防计划生活方式行为体重控制计划进行 12 次的翻译，由经过培训的非专业健康教育者在小组会议中进行。
主要观察指标
体重通过数字秤进行评估。从基线开始的体重减轻百分比和达到≥5%和≥7%体重减轻的比例进行了检查。分析于 2011 年 3 月完成。
结果
调整基线 BMI 和性别后，与对照组相比，参加生活方式项目的老年人中心的参与者体重明显减轻（3.8%，95%CI=2.9%，4.6%）（p<0.001）。在参加生活方式项目的老年人中心中，有 38%的参与者体重减轻≥5%，而对照组为 5%（p<0.001）。同样，有更多（24%）参加生活方式项目的老年人中心的参与者体重减轻≥7%，而对照组为 3%（p=0.001）。
结论
由非专业健康教育者提供的行为生活方式减肥干预为在服务不足地区翻译基于证据的肥胖治疗方案提供了有希望的手段。
试验注册
本研究在 Clinicaltrials.gov 注册，NCT01377506。
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