Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada.
Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada.
J Clin Lipidol. 2014 Mar-Apr;8(2):187-93. doi: 10.1016/j.jacl.2013.12.002. Epub 2013 Dec 11.
Although therapeutic lifestyle changes are first-line measures in treating pediatric dyslipidemia, current didactic approaches for healthy lifestyle education are weakened by low adherence and poor sustainability. A collaborative education program including a clinician-led group education class with motivational counseling complemented by the addition of peer role models was implemented.
We sought to assess the effectiveness of motivational interviewing in collaboration with peers sharing their experience and its impact on serologic and lifestyle measures vs the conventional, didactic group education approach.
Changes in lipid profiles, anthropometric measurements, nutritional scores, physical activity levels, and daily screen time after 6 months were compared both within groups and between the collaborative and the didactic approach.
We reviewed 75 children ages 11.1 ± 3.5 years (n = 38 didactic/n = 37 collaborative). There were no group differences at baseline. Total cholesterol (5.79 ± 1.65 mmol/L vs 5.52 ± 1.39 mmol/L, P = .02) significantly decreased between the initial visit and the 6-month follow-up assessment with both approaches. Nutrition compliance scores significantly improved with both approaches (median: 5.3/10 vs 6.6/10, P = .004), with a marginally greater improvement for the collaborative (+1.7/10) vs the didactic approach (+1.0/10, P = .12). The collaborative approach was associated with greater reductions in weight percentile (-8.9% vs +1.8%, P = .03) and screen time (-7.0 h/wk vs +1.3 h/wk, P = .05) and a greater increase in physical activity (+4.0 h/wk vs +2.0 h/wk, P = .05).
Although not associated with differences in lipid profiles, the collaborative educational approach was associated with a greater lifestyle improvement than was the didactic approach over a 6-month period.
尽管治疗生活方式的改变是治疗儿科血脂异常的一线措施，但目前健康生活方式教育的教学方法由于依从性低和可持续性差而受到削弱。实施了一种协作式教育计划，包括由临床医生主导的小组教育课程，辅以动机咨询，并增加同伴榜样。
我们旨在评估动机访谈与分享经验的同伴合作的有效性，及其与传统的、说教式的小组教育方法相比，对血清学和生活方式指标的影响。
比较 6 个月后脂质谱、人体测量学测量、营养评分、身体活动水平和每日屏幕时间的变化，包括组内和协作与说教方法之间的变化。
我们回顾了 75 名年龄为 11.1 ± 3.5 岁的儿童（说教组 n = 38，协作组 n = 37）。基线时两组间无差异。两种方法均使总胆固醇（5.79 ± 1.65 mmol/L 与 5.52 ± 1.39 mmol/L，P =.02）从初始就诊到 6 个月随访评估显著降低。两种方法的营养依从性评分均显著提高（中位数：5.3/10 与 6.6/10，P =.004），协作方法的改善幅度略高于说教方法（+1.7/10 与 +1.0/10，P =.12）。协作方法与体重百分位数的更大降低相关（-8.9%与+1.8%，P =.03）和屏幕时间减少（-7.0 h/wk 与+1.3 h/wk，P =.05）以及身体活动增加（+4.0 h/wk 与+2.0 h/wk，P =.05）。
尽管与血脂谱无差异相关，但在 6 个月期间，协作式教育方法与说教式方法相比，与更大的生活方式改善相关。
