Obesity (Silver Spring). 2014 Jan;22(1):131-40. doi: 10.1002/oby.20613.
To identify baseline attributes associated with consecutively missed data collection visits during the first 48 months of Look AHEAD—a randomized, controlled trial in 5,145 overweight/obese adults with type 2 diabetes designed to determine the long-term health benefits of weight loss achieved by lifestyle change.
The analyzed sample consisted of 5,016 participants who were alive at month 48 and enrolled at Look AHEAD sites. Demographic, baseline behavior, psychosocial factors, and treatment randomization were included as predictors of missed consecutive visits in proportional hazard models.
In multivariate Cox proportional hazard models, baseline attributes of participants who missed consecutive visits (n 5 222) included: younger age (hazard ratio [HR] 1.18 per 5 years younger; 95% confidence Interval 1.05, 1.30), higher depression score (HR 1.04; 1.01, 1.06), non-married status (HR 1.37; 1.04, 1.82), never self-weighing prior to enrollment (HR 2.01; 1.25, 3.23), and randomization to minimal vs. intensive lifestyle intervention (HR 1.46; 1.11, 1.91).
Younger age, symptoms of depression, non-married status, never self-weighing, and randomization to minimal intervention were associated with a higher likelihood of missing consecutive data collection visits, even in a high-retention trial like Look AHEAD. Whether modifications to screening or retention efforts targeted to these attributes might enhance long-term retention in behavioral trials requires further investigation.
确定在 LOOK AHEAD 研究的前 48 个月中连续错过数据采集访问的基线特征,这是一项针对 5145 名超重/肥胖 2 型糖尿病患者的随机对照试验,旨在确定通过生活方式改变实现减肥的长期健康益处。
分析样本包括在第 48 个月仍存活且在 LOOK AHEAD 研究点入组的 5016 名参与者。人口统计学、基线行为、心理社会因素和治疗随机分组被纳入比例风险模型,作为连续错过访问的预测因素。
在多变量 Cox 比例风险模型中,连续错过访问的参与者(n=222)的基线特征包括:年龄较小(每 5 岁年轻 1.18 倍;95%置信区间 1.05,1.30)、抑郁评分较高(HR 1.04;1.01,1.06)、未婚状态(HR 1.37;1.04,1.82)、入组前从未自行称重(HR 2.01;1.25,3.23)和随机分组至最低干预与强化生活方式干预(HR 1.46;1.11,1.91)。
即使在像 LOOK AHEAD 这样的高保留率试验中,年龄较小、抑郁症状、未婚状态、从未自行称重和随机分组至最低干预与更高的连续错过数据采集访问的可能性相关。针对这些特征的筛选或保留措施的修改是否可能提高行为试验的长期保留率,需要进一步研究。