Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
Obes Res Clin Pract. 2019 Mar-Apr;13(2):205-210. doi: 10.1016/j.orcp.2019.02.002. Epub 2019 Mar 7.
Persons with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of obesity and related chronic diseases and die 10-20years earlier than the overall population, primarily due to cardiovascular disease. In the ACHIEVE trial, a behavioural weight loss intervention led to clinically significant weight loss in persons with SMI. As the field turns its attention to intervention scale-up, it is important to understand whether the effectiveness of behavioural weight loss interventions for people with SMI, like ACHIEVE, differ for specific subgroups.
This study examined whether the effectiveness of the ACHIEVE intervention differed by participant characteristics (e.g. age, sex, race, psychiatric diagnosis, body mass index) and/or their weight-related attitudes and behaviours (e.g. eating, food preparation, and shopping habits). We used likelihood-based mixed effects models to examine whether the baseline to 18 month effects of the ACHIEVE intervention differed across subgroups.
No statistically significant differences were found in the effectiveness of the ACHIEVE intervention across any of the subgroups examined.
These findings suggest that the ACHIEVE behavioural weight loss intervention is broadly applicable to the diverse population of individuals with SMI.
患有精神疾病（如精神分裂症和双相情感障碍）的人患肥胖症和相关慢性疾病的风险增加，比一般人群早死 10-20 年，主要是由于心血管疾病。在 ACHIEVE 试验中，行为减肥干预措施导致患有精神疾病的人体重出现显著下降。随着该领域将注意力转向干预措施的扩大，了解 ACHIEVE 等针对精神疾病患者的行为减肥干预措施是否对特定亚组的有效性不同非常重要。
本研究通过参与者特征（如年龄、性别、种族、精神诊断、体重指数）和/或他们的与体重相关的态度和行为（如饮食、食物准备和购物习惯），来检验 ACHIEVE 干预措施的有效性是否因参与者而异。我们使用基于似然的混合效应模型来检验 ACHIEVE 干预措施在 18 个月内的效果是否因各个亚组的不同而有所不同。
在所检查的任何亚组中，ACHIEVE 干预措施的有效性均无统计学差异。
这些发现表明，ACHIEVE 行为减肥干预措施广泛适用于患有精神疾病的不同人群。
