School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, Australia.
JMIR Mhealth Uhealth. 2015 Jun 15;3(2):e66. doi: 10.2196/mhealth.4530.
Weight gained in young adulthood often persists throughout later life with associated chronic disease risk. Despite this, current population prevention strategies are not specifically designed for young adults.
We designed and assessed the efficacy of an mHealth prevention program, TXT2BFiT, in preventing excess weight gain and improving dietary and physical activity behaviors in young adults at increased risk of obesity and unhealthy lifestyle choices.
A two-arm, parallel-group randomized controlled trial was conducted. Subjects and analyzing researchers were blinded. A total of 250 18- to 35-year-olds with a high risk of weight gain, a body mass index (BMI) of 23.0 to 24.9 kg/m(2) with at least 2 kg of weight gain in the previous 12 months, or a BMI of 25.0 to 31.9 kg/m(2) were randomized to the intervention or control group. In the 12-week intervention period, the intervention group received 8 text messages weekly based on the transtheoretical model of behavior change, 1 email weekly, 5 personalized coaching calls, a diet booklet, and access to resources and mobile phone apps on a website. Control group participants received only 4 text messages and printed dietary and physical activity guidelines. Measured body weight and height were collected at baseline and at 12 weeks. Outcomes were assessed via online surveys at baseline and at 12 weeks, including self-reported weight and dietary and physical activity measures.
A total of 214 participants-110 intervention and 104 control-completed the 12-week intervention period. A total of 10 participants out of 250 (4.0%)-10 intervention and 0 control-dropped out, and 26 participants (10.4%)-5 intervention and 21 control-did not complete postintervention online surveys. Adherence to coaching calls and delivery of text messages was over 90%. At 12 weeks, the intervention group were 2.2 kg (95% CI 0.8-3.6) lighter than controls (P=.005). Intervention participants consumed more vegetables (P=.009), fewer sugary soft drinks (P=.002), and fewer energy-dense takeout meals (P=.001) compared to controls. They also increased their total physical activity by 252.5 MET-minutes (95% CI 1.2-503.8, P=.05) and total physical activity by 1.3 days (95% CI 0.5-2.2, P=.003) compared to controls.
The TXT2BFiT low-intensity intervention was successful in preventing weight gain with modest weight loss and improvement in lifestyle behaviors among overweight young adults. The short-term success of the 12-week intervention period shows potential. Maintenance of the behavior change will be monitored at 9 months.
The Australian New Zealand Clinical Trials Registry ACTRN12612000924853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000924853 (Archived by WebCite at http://www.webcitation.org/6Z6w9LlS9).
成年早期增加的体重通常会伴随终生，并与慢性疾病风险相关。尽管如此，目前的人群预防策略并非专门针对年轻人设计。
我们设计并评估了一种移动健康预防计划 TXT2BFiT 的效果，该计划旨在预防超重和改善年轻成年人的饮食和身体活动行为，这些年轻人超重风险较高，且生活方式不健康。
这是一项两臂、平行组随机对照试验。参与者和分析研究人员均为盲法。共有 250 名 18 至 35 岁、有体重增加高风险的参与者参与，他们的体重指数（BMI）为 23.0 至 24.9kg/m2，且在过去 12 个月中体重增加了至少 2kg，或 BMI 为 25.0 至 31.9kg/m2。参与者被随机分配至干预组或对照组。在 12 周的干预期间，干预组每周接受 8 条基于行为改变跨理论模型的短信，每周接收 1 封电子邮件，接受 5 次个性化的教练电话咨询，获得饮食小册子，并可访问网站上的资源和移动应用程序。对照组参与者仅接收 4 条短信和打印的饮食和身体活动指南。在基线和 12 周时测量体重和身高。通过基线和 12 周的在线调查评估结果，包括自我报告的体重和饮食及身体活动措施。
共有 214 名参与者（110 名干预组和 104 名对照组）完成了 12 周的干预期。共有 10 名参与者（4.0%）退出，其中 10 名（10.0%）来自干预组，0 名来自对照组，26 名参与者（10.4%）未完成干预后在线调查，其中 5 名（4.8%）来自干预组，21 名（20.2%）来自对照组。教练电话咨询的参与率和短信的发送率均超过 90%。在 12 周时，干预组比对照组轻 2.2kg（95%CI 0.8-3.6）（P=.005）。与对照组相比，干预组参与者摄入更多的蔬菜（P=.009），更少的含糖软饮料（P=.002），以及更少的高能量外卖餐（P=.001）。与对照组相比，他们的总体力活动增加了 252.5MET 分钟（95%CI 1.2-503.8，P=.05），总体力活动天数增加了 1.3 天（95%CI 0.5-2.2，P=.003）。
TXT2BFiT 这种低强度干预措施成功预防了超重年轻人的体重增加，并适度减轻了体重，改善了他们的生活方式行为。12 周干预期的短期成功表明其具有潜力。将在 9 个月时监测行为改变的维持情况。
澳大利亚和新西兰临床试验注册中心 ACTRN12612000924853；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000924853（由 WebCite 存档，http://www.webcitation.org/6Z6w9LlS9）。
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