综合动机访谈和认知行为疗法可以增加区域医院成年门诊患者的身体活动量并改善其健康状况：一项 Healthy4U 随机对照试验。
Integrated motivational interviewing and cognitive behaviour therapy can increase physical activity and improve health of adult ambulatory care patients in a regional hospital: the Healthy4U randomised controlled trial.
机构信息
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.
出版信息
BMC Public Health. 2018 Oct 11;18(1):1166. doi: 10.1186/s12889-018-6064-7.
BACKGROUND
The aim of this study was to determine whether a twelve-week, health coaching intervention could result in changes in physical activity, anthropometrics and health-related outcomes in adults presenting to an ambulatory hospital clinic.
METHODS
Seventy-two participants who reported being insufficiently active were recruited from an ambulatory hospital clinic and randomised to an intervention group that received an education session and eight 30-min telephone sessions of integrated motivational interviewing and cognitive behaviour therapy (MI-CBT), or to a control group that received the education session only. ActiGraph GT3X accelerometers were used to measure moderate-to-vigorous physical activity at baseline, post-intervention (3-months) and follow-up (6-months). Secondary outcome measures (anthropometrics, physical activity self-efficacy, health-related quality of life, type 2 diabetes risk) were also assessed at the three time points.
RESULTS
At baseline, the mean age and body mass index of participants (n = 72, 75% females) were 53 ± 8 years and 30.8 ± 4.1 kg/m, respectively. Treatment group influenced the pattern of physical activity over time (p < 0.001). The intervention group increased moderate-to-vigorous physical activity from baseline to post-intervention and remained elevated at follow-up by 12.9 min/day (95%CI: 6.5 to 19.5 min/day). In contrast, at follow-up the control group decreased moderate-to-vigorous physical activity by 9.9 min/day (95%CI: -3.7 to -16.0 min/day). Relative to control, at follow-up the intervention group exhibited beneficial changes in body mass (p < 0.001), waist circumference (p < 0.001), body mass index (p < 0.001), physical activity self-efficacy (p < 0.001), type 2 diabetes risk (p < 0.001), and health-related quality of life (p < 0.001).
CONCLUSIONS
This study demonstrates that a low contact coaching intervention results in beneficial changes in physical activity, anthropometrics and health-related outcomes that were maintained at follow-up in adults who report being insufficiently active to an ambulatory care clinic.
TRIAL REGISTRATION
ANZCTR: ACTRN12616001331426 . Registered 23 September 2016.
背景
本研究旨在确定为期十二周的健康指导干预是否能改变到门诊就诊的成年人的身体活动、人体测量学和健康相关结果。
方法
从门诊招募了 72 名报告身体活动不足的参与者，并将其随机分为干预组和对照组。干预组接受教育课程和 8 次 30 分钟的综合动机访谈和认知行为疗法（MI-CBT）电话辅导，对照组仅接受教育课程。使用 ActiGraph GT3X 加速度计在基线、干预后（3 个月）和随访（6 个月）时测量中等至剧烈强度的身体活动。在三个时间点还评估了次要结局测量（人体测量学、身体活动自我效能、健康相关生活质量、2 型糖尿病风险）。
结果
在基线时，参与者（n=72，75%为女性）的平均年龄和体重指数分别为 53±8 岁和 30.8±4.1kg/m2。治疗组对随时间变化的身体活动模式有影响（p<0.001）。干预组的中等至剧烈强度的身体活动从基线增加到干预后，并在随访时保持升高 12.9 分钟/天（95%CI：6.5 至 19.5 分钟/天）。相比之下，在随访时，对照组的中等至剧烈强度的身体活动减少了 9.9 分钟/天（95%CI：-3.7 至-16.0 分钟/天）。与对照组相比，在随访时，干预组的体重（p<0.001）、腰围（p<0.001）、体重指数（p<0.001）、身体活动自我效能（p<0.001）、2 型糖尿病风险（p<0.001）和健康相关生活质量（p<0.001）均有显著改善。
结论
本研究表明，低接触的指导干预可改善身体活动、人体测量学和健康相关结果，在报告到门诊就诊的身体活动不足的成年人中，这些结果在随访时仍保持不变。
试验注册
ANZCTR：ACTRN12616001331426。注册于 2016 年 9 月 23 日。
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