Clark D O, Keith N, Weiner M, Xu H
Indiana University Center for Aging Research Indianapolis IN USA.
Regenstrief Institute, Inc. Indianapolis IN USA.
Obes Sci Pract. 2019 Feb 8;5(2):111-119. doi: 10.1002/osp4.318. eCollection 2019 Apr.
New communication technologies have shown some promise in lifestyle weight loss interventions but may be most effective when leveraging face-to-face communications. The study reported here sought to test whether weight loss programme attendance and outcomes are greater when offered in-person at community sites or remotely via videoconference vs. in Federally Qualified Health Centers (FQHCs). In a three-arm randomized trial among 150 FQHC adults, intervention delivery in community-sites or via videoconference was tested against a clinic-based lifestyle intervention (enhanced usual care [EUC]).
Twice weekly, a nutrition topic was reviewed, and exercise sessions were held in a 20-week programme delivered either in community settings or via videoconference. The primary outcome was the proportion of participants losing more than 2 kg at 6 (end of treatment) and 12 months in intent-to-treat analyses.
Mean (SD) age was 53 years, 82% were women, 65% were African-American, 50% reported $18,000 or less household income and 49% tested low in health literacy, and mean (SD) body mass index was 39 kg m. The proportion losing more than 2 kg of weight in the community site, videoconference and EUC groups was 33%, 34% and 24%, respectively, at 6 months and 29%, 34% and 29% at 12 months. No differences reached significance. Attendance was poor in all groups; 45% of community site, 58% of videoconference and 16% of EUC participants attended at least one session.
Videoconference and community-based delivery were as effective as an FQHC-based weight loss programme.
新的通信技术在生活方式减肥干预中已显示出一定前景,但在利用面对面交流时可能最有效。本文报告的研究旨在测试在社区场所亲自提供减肥计划、通过视频会议远程提供减肥计划与在联邦合格健康中心(FQHC)提供相比时,减肥计划的参与率和效果是否更高。在一项针对150名FQHC成年人的三臂随机试验中,将社区场所或通过视频会议提供的干预措施与基于诊所的生活方式干预(强化常规护理 [EUC])进行了对比测试。
在一个为期20周的计划中,每周两次回顾营养主题并进行锻炼课程,该计划在社区环境中或通过视频会议进行。主要结局是在意向性分析中,在6个月(治疗结束时)和12个月时体重减轻超过2千克的参与者比例。
平均(标准差)年龄为53岁,82%为女性,65%为非裔美国人,50%报告家庭收入为18,000美元或以下,49%的健康素养测试得分较低,平均(标准差)体重指数为39 kg/m²。在6个月时,社区场所、视频会议和EUC组体重减轻超过2千克的比例分别为33%、34%和24%,在12个月时分别为29%、34%和29%。没有差异达到显著水平。所有组的参与率都很低;社区场所组45%、视频会议组58%和EUC组16%的参与者至少参加了一次课程。
视频会议和基于社区的减肥计划与基于FQHC的减肥计划效果相当。