Wilksch Simon M, Paxton Susan J, Byrne Susan M, Austin S Bryn, O'Shea Anne, Wade Tracey D
School of Psychology, Flinders University, South Australia, Australia.
School of Psychological Science, La Trobe University, Victoria, Australia.
Int J Eat Disord. 2017 Jan;50(1):66-75. doi: 10.1002/eat.22642. Epub 2016 Oct 21.
To investigate if baseline shape and weight concern (SWC) moderated outcomes in Prevention Across the Spectrum, a randomized-controlled trial (RCT) of 3 school-based programs aimed at reducing eating disorder and obesity risk factors.
N = 1,316 Grade 7 and 8 girls and boys (M age = 13.21 years) across three Australian states were randomly allocated to: Media Smart; Life Smart; Helping, Encouraging, Listening and Protecting Peers Initiative (HELPP) or control (usual school class). Moderation was explored by testing interaction effects for group (Media Smart; Life Smart; HELPP; Control) × moderator (SWC: higher-SWC; lower-SWC) × time (post-program; 6-month follow-up; 12-month follow-up), with baseline risk factor scores entered as covariates.
Moderation effects were found for shape concern, weight concern, eating concern, regular eating (i.e., meal skipping), physical activity, body dissatisfaction, dieting, and perfectionism. Post-hoc testing found eating concern at post-program was the only variable where higher-SWC Media Smart participants experienced a reduction in risk relative to controls. Both higher-SWC Life Smart and HELPP participants reported an increase in eating concern relative to controls and both groups were skipping more meals than controls at 12-month follow-up. Amongst lower-SWC participants, Media Smart was the only group to experience a benefit relative to controls (physical activity).
This study highlights the need for moderator analyses to become more routinely conducted in universal trials, to ensure that participants across baseline risk levels are benefiting and not harmed from program participation. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:66-75).
在“全谱预防”研究中，调查基线体型和体重担忧（SWC）是否会调节结果。“全谱预防”是一项随机对照试验（RCT），涉及3个以学校为基础的项目，旨在降低饮食失调和肥胖风险因素。
来自澳大利亚三个州的1316名7年级和8年级学生（平均年龄 = 13.21岁）被随机分配到：媒体智慧项目；生活智慧项目；帮助、鼓励、倾听和保护同伴倡议项目（HELPP）或对照组（常规学校课程）。通过测试组间交互效应（媒体智慧项目；生活智慧项目；HELPP；对照组）×调节变量（SWC：高SWC；低SWC）×时间（项目后；6个月随访；12个月随访）来探究调节作用，将基线风险因素得分作为协变量纳入分析。
发现体型担忧、体重担忧、饮食担忧、规律饮食（即不规律进食）、身体活动、身体不满意、节食和完美主义存在调节效应。事后检验发现，项目后饮食担忧是唯一一项高SWC媒体智慧项目参与者相对于对照组风险降低的变量。高SWC生活智慧项目和HELPP项目的参与者相对于对照组均报告饮食担忧增加，且在12个月随访时，这两组比对照组跳过更多餐。在低SWC参与者中（身体活动方面），媒体智慧项目是唯一相对于对照组有获益的组。
本研究强调在普遍性试验中需要更常规地进行调节分析，以确保不同基线风险水平的参与者都能从项目参与中获益而非受到伤害。© 2016威利期刊公司（《国际饮食失调杂志》2017年；50：66 - 75）
