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对英格兰北部一个郡的成人二级生活方式体重管理服务提供情况的混合方法评估。

A mixed method evaluation of adult tier 2 lifestyle weight management service provision across a county in Northern England.

作者信息

Ells L, Watson P, Carlebach S, O'Malley C, Jones D, Machaira T, Whittaker V, Clements H, Walker P, Needham K, Summerbell C, Coulton V, Araujo-Soares V

机构信息

School of Health and Social Care, Teesside University, Middlesbrough, UK.

North Yorkshire County Council, Northallerton, UK.

出版信息

Clin Obes. 2018 Jun;8(3):191-202. doi: 10.1111/cob.12250. Epub 2018 Apr 24.

Abstract

Adult obesity in the UK remains a public health priority. Current guidance recommends local areas provide multicomponent interventions to treat adults with overweight and obesity; however, there is currently a dearth of published evidence on the evaluation of these programmes. This study reports on a mixed method evaluation of seven tier 2 weight management programmes funded by a local authority in the North of England through their public health grant (a lifestyle multicomponent weight management programme for the treatment of adults with overweight and obesity, but not severe obesity, or obesity with severe co-morbidities). Data collected from over 2000 participants demonstrated that the proportion of participants achieving 5% initial body weight loss was comparable to that reported in recent UK weight management trials. Two services exceeded national criteria of 30% of participants achieving 5% initial body weight loss at 12 weeks, although long term data was limited. Greater weight loss was also observed in participants aged 35-44 and those without co-morbidities. This study provides important learning points for improvements in real world weight management services, these include: standardised data collection and management tools; staff training and communication requirements; the importance of programmes that are joined up to wider support services; and the importance of providing ongoing peer and provider support, continuous monitoring and feedback, and physical activities tailored to user needs.

摘要

英国的成人肥胖问题仍是公共卫生领域的重点。当前指南建议各地区提供多组分干预措施来治疗超重和肥胖的成年人;然而,目前关于这些项目评估的已发表证据匮乏。本研究报告了对由英格兰北部一个地方当局通过其公共卫生拨款资助的七个二级体重管理项目(一种针对超重和肥胖但非重度肥胖或伴有严重合并症的肥胖成年人的生活方式多组分体重管理项目)的混合方法评估。从2000多名参与者收集的数据表明,实现初始体重减轻5%的参与者比例与英国近期体重管理试验报告的比例相当。有两项服务超过了全国标准,即12周时30%的参与者实现初始体重减轻5%,不过长期数据有限。在35 - 44岁的参与者以及没有合并症的参与者中也观察到了更大程度的体重减轻。本研究为改善现实世界中的体重管理服务提供了重要的经验教训,这些包括:标准化的数据收集和管理工具;工作人员培训和沟通要求;与更广泛支持服务相衔接的项目的重要性;以及提供持续的同伴支持与提供者支持、持续监测和反馈,以及根据用户需求量身定制体育活动的重要性。

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