La Trobe University, La Trobe Rural Health School, PO Box 199, Bendigo, VIC, 3552, Australia.
La Trobe University, School of Psychology and Public Health, Bundoora, VIC, 3068, Australia.
BMC Public Health. 2018 Oct 5;18(1):1160. doi: 10.1186/s12889-018-6062-9.
The aim of this study was to investigate whether integrated motivational interviewing and cognitive behaviour therapy leads to changes in lifestyle mediators of overweight and obesity in community-dwelling adults.
Six electronic databases were systematically searched up to 04 October, 2017. Analyses were restricted to randomised controlled trials that examined the effect of integrated motivational interviewing and cognitive behaviour therapy on lifestyle mediators of overweight and obesity (physical activity, diet, body composition) in community-dwelling adults. Meta-analyses were conducted using change scores from baseline in outcome measures specific to the lifestyle mediators of overweight and obesity to determine standardized mean differences (SMD) and 95% confidence intervals (95% CI). The Grades of Recommendation, Assessment, Development and Evaluation approach was used to evaluate the quality of the evidence.
Ten randomised controlled trials involving 1949 participants were included. Results revealed moderate quality evidence that integrated motivational interviewing and cognitive behaviour therapy had a significant effect in increasing physical activity levels in community-dwelling adults (SMD: 0.18, 95% CI: 0.06 to 0.31, p < 0.05). The combined intervention resulted in a small, non-significant effect in body composition changes (SMD: -0.12, 95% CI: -0.24 to 0.01, p = 0.07). Insufficient evidence existed for outcome measures relating to dietary change.
The addition of integrated motivational interviewing and cognitive behaviour therapy to usual care can lead to modest improvements in physical activity and body composition for community-dwelling adults. The available evidence demonstrates that it is feasible to integrate MI with CBT and that this combined intervention has the potential to improve health-related outcomes.
This review details recommendations for future research including the adoption of uniform objective outcome measures and well-defined interventions with sufficient follow-up durations and assessments of treatment fidelity.
本研究旨在探讨综合动机访谈和认知行为疗法是否会改变社区居民超重和肥胖的生活方式中介因素。
系统检索了截至 2017 年 10 月 4 日的 6 个电子数据库。分析仅限于随机对照试验，这些试验研究了综合动机访谈和认知行为疗法对社区居民超重和肥胖的生活方式中介因素（身体活动、饮食、身体成分）的影响。使用超重和肥胖生活方式中介因素特定的结局指标的基线变化分数进行荟萃分析，以确定标准化均数差（SMD）和 95%置信区间（95%CI）。采用推荐、评估、制定和评价方法评价证据质量。
纳入了 10 项涉及 1949 名参与者的随机对照试验。结果显示，综合动机访谈和认知行为疗法可显著提高社区居民的身体活动水平，具有中等质量证据（SMD：0.18，95%CI：0.06 至 0.31，p<0.05）。联合干预对身体成分变化的效果较小且无统计学意义（SMD：-0.12，95%CI：-0.24 至 0.01，p=0.07）。关于饮食变化的结局指标，证据不足。
在常规护理的基础上增加综合动机访谈和认知行为疗法可以使社区居民的身体活动和身体成分适度改善。现有证据表明，将 MI 与 CBT 相结合是可行的，这种联合干预有可能改善与健康相关的结局。
本综述详细介绍了未来研究的建议，包括采用统一的客观结局指标和定义明确的干预措施，具有足够的随访时间和治疗依从性评估。
