Garvin Jane T, Hardy Dale, Xu Hongyan
Charlie Norwood VAMC, Augusta, Georgia, and College of Nursing, Augusta University, 987 St. Sebastian Way, EC-4346, Augusta, GA 30912. Email:
Augusta University, Augusta, Georgia.
Prev Chronic Dis. 2016 Apr 21;13:E55. doi: 10.5888/pcd13.150598.
Obesity management guidelines specify initial goals for participation and weight reduction for the first 6 months of a weight-reduction intervention, but guidelines do not specify when to assess early response and make adjustments. We aimed to determine whether very early or early weight reduction in the weight-reduction program MOVE! predicted later participation or achievement of weight-reduction goals.
Using clinical data from 375 MOVE! participants enrolled from July 2008 through May 2010, we examined program participation and weight reduction. Very early response was defined as achieving a weight reduction of 0.5% or more at week 2, and early response was defined as achieving weight reduction of 1.0% or more at week 4. Success, or achievement of weight-reduction goal, at 6 months, 1 year, and 2 years was defined as a weight reduction of 5% or more. Participation was assessed according to the number of sessions attended within the first 6 months of program enrollment; attendance of 14 or more sessions was classified as high-intensity participation.
Very early responders were more than 5 times as likely (odds ratio [OR] = 5.46; 95% confidence interval [CI], 1.69-17.71; P = .005) and early responders were more than 10 times as likely (OR = 10.76; 95% CI, 2.64-43.80; P = .001) to achieve the 6-month weight-reduction goal as participants who were not very early responders or early responders, respectively. Early responders were almost 7 times as likely to achieve the 1-year weight-reduction goal (OR = 6.96; 95% CI, 1.85-26.13; P = .004). Neither very early nor early response predicted participation, high-intensity participation, or success at 2 years.
This research supports the predictive value of very early response and early response to MOVE! on weight-reduction success at 6 months; early response also predicted 1-year success, suggesting that the 2-week point may be an ideal time to assess initial response and make intervention adjustments.
肥胖管理指南规定了减肥干预前6个月的参与初始目标和体重减轻目标，但未明确何时评估早期反应并进行调整。我们旨在确定在“行动！”减肥计划中极早期或早期体重减轻是否能预测后期的参与情况或减肥目标的实现。
利用2008年7月至2010年5月期间375名“行动！”参与者的临床数据，我们对计划参与情况和体重减轻进行了研究。极早期反应定义为在第2周体重减轻0.5%或更多，早期反应定义为在第4周体重减轻1.0%或更多。6个月、1年和2年时的成功或减肥目标实现定义为体重减轻5%或更多。根据计划登记后前6个月内参加的课程数量评估参与情况；参加14节或更多课程被归类为高强度参与。
极早期反应者实现6个月减肥目标的可能性是未出现极早期反应者的5倍多（优势比[OR]=5.46；95%置信区间[CI]，1.69-17.71；P=0.005），早期反应者实现6个月减肥目标的可能性是未出现早期反应者的10倍多（OR=10.76；95%CI，2.64-43.80；P=0.001）。早期反应者实现1年减肥目标的可能性几乎是未出现早期反应者的7倍（OR=6.96；95%CI，1.85-26.13；P=0.004）。极早期反应和早期反应均未预测2年时的参与情况、高强度参与情况或成功情况。
本研究支持极早期反应和早期反应对“行动！”减肥计划减肥成功的预测价值；早期反应还预测了1年时的成功，表明第2周这一时间点可能是评估初始反应并进行干预调整的理想时机。
