Lewis Zakkoyya H, Ottenbacher Kenneth J, Fisher Steve R, Jennings Kristofer, Brown Arleen F, Swartz Maria C, Martinez Eloisa, Lyons Elizabeth J
University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77551, USA.
Beachbody LLC, 3301 Exposition Blvd, Santa Monica, CA, 90404, USA.
Int J Behav Nutr Phys Act. 2017 Aug 14;14(1):106. doi: 10.1186/s12966-017-0560-5.
Conducting 5 A's counseling in clinic and utilizing technology-based resources are recommended to promote physical activity but little is known about how to implement such an intervention. This investigation aimed to determine the feasibility and acceptability, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, of a pragmatic, primary care-based intervention that incorporated 5 A's counseling and self-control through an activity monitor.
Primary care patients (n = 40) 55-74 years of age were recruited and randomized to receive a pedometer or an electronic activity monitor (EAM), Jawbone UP24, to monitor activity for 12 weeks. Participants were also invited to a focus group after completing the intervention. Stakeholders (n = 36) were recruited to provide feedback.
The intervention recruitment rate was 24.7%. The attrition rate was 20% with a significantly higher rate for the pedometer group (p = 0.02). The EAM group increased their minutes of physical activity by 11.1 min/day while the pedometer maintained their activity (0.2 min/day), with no significant group difference. EAM participants liked using their monitor and would continue wearing it while the pedometer group was neutral to these statements (p < 0.05). Over the 12 weeks there were 490 comments and 1094 "likes" given to study peers in the corresponding application for the UP24 monitor. Some EAM participants enjoyed the social interaction feature while others were uncomfortable talking to strangers. Participants stated they would want counseling from a counselor and not their physician or a nurse. Other notable comments included incorporating multiple health behaviors, more in-person counseling with a counselor, and having a funding source for sustainability.
Overall, the study was well-received but the results raise a number of considerations. Practitioners, counselors, and researchers should consider the following before implementing a similar intervention: 1) utilize PA counselors, 2) target multiple health behaviors, 3) form a social support group, 4) identify a funding source for sustainability, and 5) be mindful of concerns with technology.
clinicaltrials.gov- NCT02554435 . Registered 24 August 2015.
建议在临床中开展5A's咨询并利用基于技术的资源来促进身体活动，但对于如何实施此类干预知之甚少。本研究旨在使用RE-AIM（覆盖范围、有效性、采用率、实施情况、维持情况）框架，确定一项基于初级保健的务实干预措施的可行性和可接受性，该干预措施通过活动监测器纳入了5A's咨询和自我控制。
招募年龄在55-74岁的初级保健患者（n = 40），并随机分为接受计步器或电子活动监测器（EAM，Jawbone UP24），以监测活动12周。干预结束后，还邀请参与者参加焦点小组。招募利益相关者（n = 36）以提供反馈。
干预招募率为24.7%。损耗率为20%，计步器组的损耗率显著更高（p = 0.02）。EAM组的身体活动分钟数增加了11.1分钟/天，而计步器组的活动量保持不变（0.2分钟/天），两组之间无显著差异。EAM参与者喜欢使用他们的监测器，并会继续佩戴，而计步器组对这些说法持中立态度（p < 0.05）。在12周内，针对UP24监测器的相应应用程序，研究同伴收到了490条评论和1094个“赞”。一些EAM参与者喜欢社交互动功能，而另一些人则不喜欢与陌生人交谈。参与者表示他们希望得到咨询师的咨询，而不是他们的医生或护士。其他值得注意的评论包括纳入多种健康行为、与咨询师进行更多面对面咨询以及有可持续发展的资金来源。
总体而言，该研究受到好评，但结果引发了一些思考。从业者、咨询师和研究人员在实施类似干预之前应考虑以下几点：1）利用身体活动咨询师；2）针对多种健康行为；3）组建社会支持小组；4）确定可持续发展的资金来源；5）关注技术相关问题。
clinicaltrials.gov - NCT02554435。2015年8月24日注册。
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