Relationship between intervention dose and outcomes in living well with diabetes--a randomized trial of a telephone-delivered lifestyle-based weight loss intervention.

作者信息

Goode Ana D, Winkler Elisabeth A H, Reeves Marina M, Eakin Elizabeth G

出版信息

Am J Health Promot. 2015 Nov-Dec;30(2):120-9. doi: 10.4278/ajhp.140206-QUAN-62. Epub 2014 Nov 5.

Abstract

PURPOSE

To examine associations of intervention dose with weight, physical activity, glycemic control, and diet outcomes in a randomized trial of a telephone counseling intervention.

DESIGN

Study design was a secondary analysis of intervention group.

SETTING

Study setting was primary care practices in a disadvantaged community in Australia.

SUBJECTS

Participants were adult patients with type 2 diabetes (n = 151).

INTERVENTION

Up to 27 telephone counseling calls were made during 18 months.

MEASURES

Intervention dose was assessed as the number of calls completed (in tertile categories). Primary outcomes were weight and HbA1c, and moderate to vigorous intensity physical activity via accelerometer. Secondary outcomes were dietary energy intake and diet quality via a validated questionnaire.

ANALYSIS

Analyses employed were bivariate associations of call completion with sociodemographics, and confounder-adjusted linear mixed models for associations of call completion with outcomes (multiple imputation of missing data).

RESULTS

Only previous diagnosis of depression/anxiety had a statistically significant (p = .008) association with call completion. Call completion was significantly associated with weight loss (p < .001) but not the other outcomes (p > .05). Relative to low call completion, mean weight loss (as a percentage of baseline weight) was greater in the high-call completion group by -3.3% (95% confidence interval, -5.0% to -1.5%).

CONCLUSION

Increased dose of intervention was associated with greater weight loss. More needs to be done to retain patients for the duration of weight loss and behavior change interventions, particularly those with diabetes and comorbid depression, who were the most difficult to engage.

摘要

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