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挪威健康生活中心研究:初级保健中体力活动的实用随机对照试验。

The Norwegian Healthy Life Centre Study: A pragmatic RCT of physical activity in primary care.

机构信息

1 Department of Global Public Health and Primary Care, University of Bergen, Norway.

2 Department for Research and Development, Haukeland University Hospital, Bergen, Norway.

出版信息

Scand J Public Health. 2019 Feb;47(1):18-27. doi: 10.1177/1403494818785260. Epub 2018 Aug 3.

Abstract

AIMS

The aim of this study was to evaluate the effect of behaviour change interventions at Norwegian Healthy Life Centres (HLCs) on participants' moderate to vigorous intensity physical activity (MVPA) six months after baseline. We also explore predictors of change in MVPA, and if level of education and MVPA at baseline modify the effect.

METHODS

A randomised controlled trial with inclusion criteria age ⩾ 18 years and ability to participate in group-based physical activity. Participants were randomised to either behaviour change interventions or a waiting list (control). Objective recordings of physical activity were the main outcome, analysed with simple and multiple linear regression.

RESULTS

We recruited 118 participants from six HLCs. Participants with mental, musculoskeletal, or chronic somatic disease were more likely to drop out. We revealed no differences in MVPA or sedentary time between the groups. Types of motivation or several characteristics of disadvantage at baseline could not explain changes in MVPA. Across both groups, 83% achieved the recommended 150 minutes of MVPA per week, and participants with a lower level of education were less likely to improve. Participants in the intervention group who were least active at baseline significantly increased their MVPA.

CONCLUSIONS

The study revealed that the intervention had no short-term effect on time spent on MVPA or sedentary. This study does not support a strong emphasis on behaviour change on an individual level as a way of targeting general health and risk reduction at a population level. Although less active people benefitted more from the HLC intervention, the intervention was unable to counteract widening of inequity across educational groups.

摘要

目的

本研究旨在评估挪威健康生活中心(HLC)的行为改变干预措施对参与者在基线后六个月的中等到剧烈强度体力活动(MVPA)的影响。我们还探讨了 MVPA 变化的预测因素,以及教育程度和基线 MVPA 是否会改变干预效果。

方法

这是一项随机对照试验,纳入标准为年龄 ⩾ 18 岁且有能力参加团体体能活动。参与者被随机分配到行为改变干预组或等待名单(对照组)。主要结局是客观记录的体力活动,采用简单和多元线性回归进行分析。

结果

我们从六个 HLC 招募了 118 名参与者。有精神、肌肉骨骼或慢性躯体疾病的参与者更有可能中途退出。我们没有发现两组之间的 MVPA 或久坐时间有差异。动机类型或基线时的一些劣势特征无法解释 MVPA 的变化。在两个组中,83%的人达到了每周 150 分钟的推荐 MVPA,受教育程度较低的人则不太可能提高。基线时活动量最低的干预组参与者明显增加了他们的 MVPA。

结论

该研究表明,干预措施在短期内对 MVPA 或久坐时间没有影响。本研究不支持在个体层面上过分强调行为改变,作为针对人群健康和降低风险的一种方法。尽管活动量较少的人从 HLC 干预中获益更多,但干预措施未能抵消教育程度不同的人群之间不平等程度的扩大。

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