Hartman Sheri J, Risica Patricia M, Gans Kim M, Marcus Bess H, Eaton Charles B
Program in Public Health, Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA, USA; Cancer Prevention and Control, University of California San Diego Moores Cancer Center, San Diego, CA, USA.
Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI, USA; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
Contemp Clin Trials. 2014 Jul;38(2):409-19. doi: 10.1016/j.cct.2014.06.001. Epub 2014 Jun 15.
Although there are efficacious weight loss interventions that can improve health and delay onset of diabetes and hypertension, these interventions have not been translated into clinical practice. The primary objective of this study is to evaluate the effectiveness and cost effectiveness of a tailored lifestyle intervention in primary care patients. Patients were recruited by their primary care physicians and eligible participants were randomized to an enhanced intervention or standard intervention. All participants met with a lifestyle counselor to set calorie and physical activity goals and to discuss behavioral strategies at baseline, 6 and 12 months. During the first year, enhanced intervention participants receive monthly counseling phone calls to assist in attaining and maintaining their goals. Enhanced intervention participants also receive weekly mailings consisting of tailored and non-tailored print materials and videos focusing on weight loss, physical activity promotion and healthy eating. The second year focuses on maintenance with enhanced intervention participants receiving tailored and non-tailored print materials and videos regularly throughout the year. Standard intervention participants receive five informational handouts on weight loss across the two years. This enhanced intervention that consists of multiple modalities of print, telephone, and video with limited face-to-face counseling holds promise for being effective for encouraging weight loss, increasing physical activity and healthy eating, and also for being cost effective and generalizable for wide clinical use. This study will fill an important gap in our knowledge regarding the translation and dissemination of research from efficacy studies to best practices in clinical settings.
尽管存在有效的减肥干预措施，能够改善健康状况并延缓糖尿病和高血压的发病，但这些干预措施尚未转化为临床实践。本研究的主要目的是评估针对初级保健患者的个性化生活方式干预的有效性和成本效益。患者由其初级保健医生招募，符合条件的参与者被随机分配到强化干预组或标准干预组。所有参与者在基线、6个月和12个月时与生活方式顾问会面，设定卡路里和身体活动目标，并讨论行为策略。在第一年，强化干预组的参与者每月会接到咨询电话，以协助他们实现并维持目标。强化干预组的参与者还会每周收到邮件，其中包括针对减肥、促进身体活动和健康饮食的个性化和非个性化印刷材料及视频。第二年重点在于维持，强化干预组的参与者全年定期收到个性化和非个性化的印刷材料及视频。标准干预组的参与者在两年内会收到五份关于减肥的信息手册。这种由印刷品、电话和视频等多种形式组成且面对面咨询有限的强化干预，有望有效地促进减肥、增加身体活动和健康饮食，并且具有成本效益且可广泛应用于临床。本研究将填补我们在将疗效研究成果转化并传播为临床最佳实践方面的重要知识空白。
