Associate Professor and Director of the CHANGE Alberta research group in the Department of Family Medicine at the University of Alberta in Edmonton.
Gastroenterologist at St Michael's Hospital in Toronto, Ont, and Professor of Medicine in the Faculty of Medicine at the University of Toronto.
Can Fam Physician. 2017 Jul;63(7):546-552.
Primary care settings require a feasible program for integrating lifestyle interventions, which can reverse metabolic abnormalities, for patients in practice.
To integrate a lifestyle intervention program into existing primary care clinics with an interprofessional approach that includes dietitians and kinesiologists.
Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) provides a personalized approach to nutrition and exercise modification focusing on patients with metabolic syndrome. With CHANGE, exercise intervention is individualized (ie, tailored to individual preferences) and graded (ie, intensity is built up slowly over time); supervision and implementation of the program is conducted in a collaborative fashion between the family physician and the kinesiologist. Patients undergo an initial fitness assessment that determines their baseline aerobic, strength, and flexibility scores, and the same assessment is performed at 3 months and at 12 months.
The CHANGE program demonstrates how interprofessional primary care teams can support patients with metabolic syndrome in achieving their health goals. By including dietitians and kinesiologists in primary care settings to work alongside family doctors, many barriers to lifestyle interventions can be overcome. The team's collaborative understanding of the patient combined with the patient's own sense of urgency for change creates the opportunity for the formation of new healthy lifestyle habits. Although results are preliminary, CHANGE appears to be a feasible, implementable, and effective program.
初级保健机构需要一个可行的方案，将生活方式干预措施融入实践中的患者，以逆转代谢异常。
通过采用包括营养师和运动生理学家在内的跨专业方法，将生活方式干预方案纳入现有的初级保健诊所。
加拿大健康促进营养与分级运动（CHANGE）为营养和运动调整提供了一种个性化的方法，重点关注代谢综合征患者。在 CHANGE 中，运动干预是个体化的（即根据个人偏好定制）和分级的（即强度随时间逐渐增加）；家庭医生和运动生理学家以协作的方式对该方案进行监督和实施。患者接受初始健身评估，以确定他们的有氧、力量和灵活性基线评分，并且在 3 个月和 12 个月时进行相同的评估。
CHANGE 方案展示了跨专业初级保健团队如何帮助代谢综合征患者实现健康目标。通过在初级保健环境中让营养师和运动生理学家与家庭医生一起工作，可以克服许多生活方式干预措施的障碍。团队对患者的协作式理解以及患者自身对改变的迫切感为形成新的健康生活习惯创造了机会。尽管结果尚属初步，但 CHANGE 似乎是一个可行、可实施且有效的方案。
