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针对代谢综合征患者的基于网络的生活方式干预中的依从性和损耗情况

Adherence and Attrition in a Web-Based Lifestyle Intervention for People with Metabolic Syndrome.

作者信息

Jahangiry Leila, Shojaeizadeh Davoud, Montazeri Ali, Najafi Mahdi, Mohammad Kazem, Yaseri Mehdi

机构信息

1. Dept. of Health Education and Health Promotion, School of Public Health, Tabriz University of Medical Sciences , Tabriz, Iran.

2. Dept. of Health Education and Health Promotion, School of Public Health, Tehran University of Medical Sciences , Tehran, Iran.

出版信息

Iran J Public Health. 2014 Sep;43(9):1248-58.

Abstract

BACKGROUND

The aim of this study was to determine adherence and attrition rates in a lifestyle intervention for people with metabolic syndrome.

METHODS

Adherence and attrition data from a randomized controlled trial were collected. Participants were classified as adherence group if they completed assessments at 3 and 6 months follow-up and as attrition group if they did not. Physical activity and quality of life was measured using the International Physical Activity Questionnaire (IPAQ) and the Short Form Health Survey (SF-36). Generalized Estimating Equations (GEE) was used to explore predictors of attrition.

RESULTS

The mean age of participants (n=160) was 44.1 years. Attrition rate in the intervention and control groups at first follow-up were the same (20%). However, the control group had significantly higher attrition rate (%33.7) compared to the intervention group (%20) at 6 months follow up. Results showed that low educated participants were more likely to not stay in the study than better educated participants (OR=2.95,CI:1.39-6.33,P=0.05). According with length of the study, attrition was decreased at six month (OR=0.66,CI:0.52-0.83,P<0.001). Also, some aspects of health-related quality of life contributed to the attrition rate. Those who had higher scores on general health (OR=0.66,CI:0.54-0.97,P=0.023), social functioning (OR=0.44,CI:0.40-0.76,P=0.032), role emotional (OR=0.74,CI:0.54-0.98,P=0.18), vitality (OR=0.55,CI:0.38-0.90,P=0.015) and mental health (OR=0.63,CI:0.45-0.85,P=0.033) were more likely to stay in the study.

CONCLUSION

It remains a concern that Web-based lifestyle programs may fail to reach those who need it most. Participant in the study generally had better quality of life than those who were lost to follow up.

摘要

背景

本研究旨在确定针对代谢综合征患者的生活方式干预中的依从率和失访率。

方法

收集了一项随机对照试验中的依从性和失访数据。如果参与者在3个月和6个月的随访中完成了评估,则被归类为依从组;如果未完成,则被归类为失访组。使用国际体力活动问卷(IPAQ)和简短健康调查(SF-36)测量身体活动和生活质量。采用广义估计方程(GEE)来探索失访的预测因素。

结果

参与者(n = 160)的平均年龄为44.1岁。干预组和对照组在首次随访时的失访率相同(20%)。然而,在6个月随访时,对照组的失访率(33.7%)显著高于干预组(20%)。结果显示,受教育程度低的参与者比受教育程度高的参与者更有可能退出研究(OR = 2.95,CI:1.39 - 6.33,P = 0.05)。随着研究时间的延长,6个月时的失访率降低(OR = 0.66,CI:0.52 - 0.83,P < 0.001)。此外,健康相关生活质量的某些方面也导致了失访率。在总体健康(OR = 0.66,CI:0.54 - 0.97,P = 0.023)、社会功能(OR = 0.44,CI:0.40 - 0.76,P = 0.032)、角色情感(OR = 0.74,CI:0.54 - 0.98,P = 0.18)、活力(OR = 0.55,CI:0.38 - 0.90,P = 0.015)和心理健康(OR = 0.63,CI:0.45 - 0.85,P = 0.033)方面得分较高的人更有可能留在研究中。

结论

基于网络的生活方式项目可能无法惠及最需要的人群,这仍然是一个令人担忧的问题。研究中的参与者总体生活质量高于失访者。

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