O'Hara Blythe J, Phongsavan Philayrath, Rissel Chris, Hardy Louise L, Zander Alexis, Greenaway Mark, Bauman Adrian E
Aust J Prim Health. 2015;21(2):182-8. doi: 10.1071/PY13154.
A lifestyle-modification telephone-based service is delivered in New South Wales (NSW; the Get Healthy Information and Coaching Service (GHS)) as an important obesity-prevention, population-wide program. The present study examined referrals from general practitioners (GP) versus self-referral to the GHS in terms of risk profile and effectiveness of outcomes. The study used a pre-post test design to assess changes in outcomes within the setting of a telephone-based lifestyle-support service available to NSW adults (18+ years) who self-referred or were referred by their health practitioner and/or GP, and registered for the GHS between February 2009 and August 2013 (n = 22 183). The GHS has two service components: (1) the provision of an information kit (one off contact) on healthy eating, being physically active and achieving and/or maintaining a healthy weight; and (2) a 6-month coaching program that includes 10 telephone calls aimed at achieving and maintaining lifestyle-related goals. Sociodemographic characteristics, referral source and self-reported anthropometric (height, waist and waist circumference (WC)) and behavioural risk factor (physical activity and nutrition-related behaviours) data were collected at baseline and at 6 months. Analysis revealed that GPs effectively recruited hard-to-reach subtargets, as well as adults who are obese and have an increased WC risk. Participants in the GHS coaching program, irrespective of GHS referral source, reported a mean weight loss of -3.8 kg, a decrease in WC of -5.0 cm and increases in both fruit and vegetable consumption and physical activity. In conclusion, GPs have an important role in GHS uptake (through proactive referral or as an adjunct to practice-based interventions) because they can recruit those most at need and facilitate improvements in their patients' risk factor profiles.
新南威尔士州(NSW)提供了一项基于电话的生活方式改善服务(即“健康获取信息与指导服务”(GHS)),作为一项重要的全人群肥胖预防计划。本研究从风险状况和结果有效性方面,对全科医生(GP)转诊与自我转诊至GHS的情况进行了调查。该研究采用前后测试设计,以评估在一项基于电话的生活方式支持服务中,新南威尔士州18岁及以上自我转诊或由其健康从业者和/或全科医生转诊并于2009年2月至2013年8月注册GHS的成年人(n = 22183)的结果变化。GHS有两个服务组成部分:(1)提供一份关于健康饮食、体育锻炼以及实现和/或维持健康体重的信息包(一次性接触);(2)一个为期6个月的指导计划,包括10次电话咨询,旨在实现和维持与生活方式相关的目标。在基线和6个月时收集了社会人口统计学特征、转诊来源以及自我报告的人体测量数据(身高、腰围和臀围(WC))和行为风险因素(体育活动和与营养相关的行为)数据。分析表明,全科医生有效地招募了难以接触到的子目标人群,以及肥胖且腰围风险增加的成年人。GHS指导计划的参与者,无论其转诊来源如何,报告平均体重减轻了-3.8千克,腰围减少了-5.0厘米,水果和蔬菜摄入量以及体育活动均有所增加。总之,全科医生在GHS的推广中发挥着重要作用(通过主动转诊或作为基于实践的干预措施的辅助手段),因为他们可以招募最需要的人群,并促进改善患者的风险因素状况。