可实现的体重减轻:为行动不便的成年人调整生活方式干预措施。
Accessible weight loss: Adapting a lifestyle intervention for adults with impaired mobility.
作者信息
Betts Andrea C, Froehlich-Grobe Katherine
机构信息
Baylor Institute for Rehabilitation, Dallas, TX, USA; Division of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Dallas Regional Campus, USA.
Baylor Institute for Rehabilitation, Dallas, TX, USA.
出版信息
Disabil Health J. 2017 Jan;10(1):139-144. doi: 10.1016/j.dhjo.2016.06.004. Epub 2016 Jun 21.
BACKGROUND
Despite disparities in obesity between those with and without disability, there is limited evidence to guide weight loss intervention in people with impaired mobility (IM), particularly those with severe impairments.
OBJECTIVE
Examine the usability, feasibility, and effectiveness of adapting an existing evidence-based weight loss program for people with IM.
METHODS
In this single-group pre-test post-test pilot study, 10 overweight or obese individuals with permanent IM (e.g. spinal cord injury, spina bifida, osteoarthritis) participated in a 20-week modification of the DPP Group Lifestyle Balance™ (DPP GLB) program, a group-based adaptation of the Diabetes Prevention Program (DPP). Fifteen conference calls encouraged reducing calorie and fat intake and increasing exercise through self-monitoring and problem solving. We defined feasibility as retention and engagement, usability as participants' program satisfaction ratings, and effectiveness as physiological and psychosocial change measured on three occasions over 20 weeks. Analytic methods included basic descriptive statistics (feasibility and usability) and repeated measures ANOVA (effectiveness).
RESULTS
The program retained 70% of participants. These individuals attended an average of 79.3% of conference calls and self-monitored more than half of the weeks. Participants rated the program highly, with mean overall scores of 6.3 ± 0.3 and 6.2 ± 0.6 out of 7 on helpfulness and satisfaction scales, respectively. Program completers experienced a significant mean weight loss of 8.86 ± 8.37 kg (p = 0.024), or 7.4% of their start weight, and significantly reduced their BMI.
CONCLUSIONS
An adapted version of the DPP GLB is a feasible, usable, and potentially effective intervention for promoting weight loss among persons with IM.
背景
尽管残疾人和非残疾人在肥胖方面存在差异,但针对行动不便者(IM),尤其是严重行动不便者的体重减轻干预措施的证据有限。
目的
研究将现有的循证体重减轻计划改编后应用于行动不便者的可用性、可行性和有效性。
方法
在这项单组前后测试点研究中,10名患有永久性行动不便(如脊髓损伤、脊柱裂、骨关节炎)的超重或肥胖个体参与了为期20周的糖尿病预防计划(DPP)小组生活方式平衡(DPP GLB)计划的改编版,该计划是基于小组的糖尿病预防计划改编版。15次电话会议鼓励通过自我监测和解决问题来减少卡路里和脂肪摄入并增加运动量。我们将可行性定义为留存率和参与度,将可用性定义为参与者对计划的满意度评分,将有效性定义为在20周内分三次测量的生理和心理社会变化。分析方法包括基本描述性统计(可行性和可用性)和重复测量方差分析(有效性)。
结果
该计划的参与者留存率为70%。这些个体平均参加了79.3%的电话会议,并且在超过半数的周数里进行了自我监测。参与者对该计划评价很高,在帮助程度和满意度量表上的平均总分分别为6.3±0.3和6.2±0.6(满分7分)。完成计划的参与者平均体重显著减轻了8.86±8.37千克(p=0.024),即起始体重的7.4%,并且BMI显著降低。
结论
改编后的DPP GLB是一种可行、可用且可能有效的干预措施,可促进行动不便者体重减轻。