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电话式辅导在糖尿病高危成人中的应用:澳大利亚“健康生活服务”的影响。

Telephone based coaching for adults at risk of diabetes: impact of Australia's Get Healthy Service.

机构信息

Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, Australia.

Charles Perkins Centre, University of Sydney, Sydney, Australia.

出版信息

Transl Behav Med. 2019 Nov 25;9(6):1178-1185. doi: 10.1093/tbm/ibz007.

Abstract

The Get Healthy Information and Coaching Service (GHS), an effective 6-month telephone-based healthy lifestyle coaching service, includes a population-targeted diabetes prevention module (DPM) tailored for adults at risk for type 2 diabetes. This study determined DPM's reach and impact on anthropometric and lifestyle risk factors. Pre-post evaluation design examined self-reported anthropometric (body weight, waist circumference) and lifestyle risk factors (physical activity and dietary behaviors) of DPM participants. Descriptive and chi-square analyses were performed on sociodemographic variables. Behavioral changes were assessed using matched pairs analysis, independent samples analysis, and multivariate analysis. There were 4,222 DPM participants (76.0% female; 75.9% aged ≥ 50; 95.4% spoke English at home). The DPM included higher proportions of older adults (≥50) (75.9% vs. 46.5%; p < .001), retirees (28.7% vs. 18.5%; p < .0001), less educated (33.3% vs. 24.9%; p < .0001), more disadvantaged (41.7% vs. 34.8%; p < .001) and living in regional or rural areas (43.2% vs. 39.8%; p < .001) than the GHS program. DPM participants reported significant improvements at six months for all anthropometric (-3.3 kg weight; -1.2 BMI units; -4.3 cm waist circumference) and behavioral risk factors (+0.2 fruit serves/day; +0.7 vegetables serves/day; -0.2 sweetened drinks/day; -0.2 takeaway meals/week; +1.1 30-min walking sessions/week; +0.7 30-min moderate activity sessions/week; +0.2 20-min vigorous activity sessions/week). Nearly one-third (31.1%) of participants lost ≥5% body weight. The DPM reached priority population groups, those typically underrepresented in diabetes prevention programs and resulted in clinically relevant improvements in anthropometric and lifestyle risk factors in adults at increased risk for type 2 diabetes.

摘要

获取健康信息和辅导服务(GHS)是一种有效的基于电话的 6 个月健康生活方式辅导服务,包括针对有 2 型糖尿病风险的成年人的人群定向糖尿病预防模块(DPM)。本研究旨在确定 DPM 的覆盖范围及其对人体测量和生活方式风险因素的影响。在预-后评估设计中,我们检查了 DPM 参与者的自我报告人体测量指标(体重、腰围)和生活方式风险因素(身体活动和饮食行为)。对社会人口统计学变量进行了描述性和卡方分析。使用匹配对分析、独立样本分析和多变量分析评估行为变化。共有 4222 名 DPM 参与者(76.0%为女性;75.9%年龄≥50 岁;95.4%在家说英语)。DPM 包括更高比例的老年人(≥50 岁)(75.9% vs. 46.5%;p<.001)、退休人员(28.7% vs. 18.5%;p<.0001)、受教育程度较低的人(33.3% vs. 24.9%;p<.0001)、更贫困的人(41.7% vs. 34.8%;p<.001)和居住在地区或农村地区的人(43.2% vs. 39.8%;p<.001),而非 GHS 项目。DPM 参与者在六个月时报告所有人体测量指标(体重减轻 3.3 公斤;BMI 单位减少 1.2;腰围减少 4.3 厘米)和行为风险因素(每天增加 0.2 份水果;每天增加 0.7 份蔬菜;每天减少 0.2 份含糖饮料;每周减少 0.2 份外卖;每周增加 1.1 次 30 分钟步行;每周增加 0.7 次 30 分钟中等强度活动;每周增加 0.2 次 20 分钟剧烈活动)均有显著改善。近三分之一(31.1%)的参与者体重减轻≥5%。DPM 覆盖了重点人群,即那些通常在糖尿病预防计划中代表性不足的人群,使有 2 型糖尿病风险的成年人的人体测量和生活方式风险因素得到了临床相关的改善。

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