Work It Out 项目对城市原住民和托雷斯海峡岛民慢性病自我管理的影响：身体活动能力和人体测量指标的变化。

Changes in exercise capacity and anthropometric measures after Work It Out-a holistic chronic disease self-management program for urban Aboriginal and Torres Strait Islander people.

机构信息

The Institute for Urban Indigenous Health, 22 Cox Road, Windsor, Brisbane, QLD, 4030, Australia.

出版信息

Public Health. 2019 Sep;174:49-55. doi: 10.1016/j.puhe.2019.05.035. Epub 2019 Jul 15.

DOI:10.1016/j.puhe.2019.05.035

PMID:31319317

Abstract

OBJECTIVES

The Work It Out (WIO) program is a holistic chronic disease self-management and rehabilitation program in Queensland that is tailored for urban Aboriginal and Torres Strait Islander people with/at risk of chronic disease. This study aimed to examine the overall changes in participants' exercise capacity and anthropometric measurements and to explore the correlations between these changes.

STUDY DESIGN

Quasi-experimental prepost intervention study.

METHODS

A total of 406 participants self-identified as Aboriginal and Torres Strait Islander people, who had attended one or more cycles of the program from 2014 to 2017, were included. Health information from the last review assessment was compared with that of the initial assessment using paired t-tests. Multivariate regression models were applied to explore the associations between changes in 6-min walk distance (6MWD) and anthropometric measurements.

RESULTS

An increase in 6MWD (77 m, 95% confidence interval [CI]: 65, 90), as well as small reductions in waist circumference (WC) (-1.79 cm, 95% CI: -2.76 to -0.82) and hip circumference (-1.11 cm, 95% CI: -2.13 to -0.08) were identified. Statistically significant reductions were observed across all anthropometric measures in the respective highest tertiles (body mass index: -0.71, 95% CI: -1.35 to -0.07; weight: -2.59 kg, 95% CI: -4.84 to -0.34; WC: -5.09 cm, 95% CI: -6.99 to -3.20; waist to hip ratio: -0.033, 95% CI: -0.047 to -0.02). The increments of 6MWD in returning participants (92 m, 95% CI: 75 to 109) was found to be greater than those in one-off participants (59 m, 95% CI: 40-78). In particular, the percentage of 6MWD change from baseline was significantly correlated to the percentage of WC change after adjusting for age, gender, the number of pre-existing chronic conditions, and the number of cycles attended (coefficient: -1.33, 95% CI: -2.42 to -0.24).

CONCLUSION

Significant improvement in functional exercise capacity and modest changes in anthropometric measurements were identified in WIO participants. WC change could be used as an indicator of the change of participants' six-minute walk distance. Findings may be useful for promoting and guiding similar health programs for improving chronic disease management in Australian Indigenous communities.

摘要

目的

Work It Out（WIO）计划是昆士兰州的一项针对有/患有慢性病风险的城市原住民和托雷斯海峡岛民的整体慢性病自我管理和康复计划。本研究旨在检查参与者的运动能力和人体测量学测量值的总体变化，并探讨这些变化之间的相关性。

研究设计

准实验前后干预研究。

方法

共有 406 名自认为是原住民和托雷斯海峡岛民的参与者参加了 2014 年至 2017 年期间的一个或多个周期的该计划。使用配对 t 检验将最后一次审查评估的健康信息与初始评估进行比较。应用多元回归模型探讨 6 分钟步行距离（6MWD）变化与人体测量学测量值之间的关系。

结果

发现 6MWD 增加（77m，95%置信区间[CI]：65，90），腰围（WC）减少（-1.79cm，95%CI：-2.76 至 -0.82）和臀围减少（-1.11cm，95%CI：-2.13 至 -0.08）。在各自的最高三分位中，所有人体测量指标均观察到统计学显著降低（体重指数：-0.71，95%CI：-1.35 至 -0.07；体重：-2.59kg，95%CI：-4.84 至 -0.34；WC：-5.09cm，95%CI：-6.99 至 -3.20；腰臀比：-0.033，95%CI：-0.047 至 -0.02）。发现回归参与者的 6MWD 增量（92m，95%CI：75 至 109）大于单次参与者的增量（59m，95%CI：40 至 78）。特别是，在调整年龄、性别、现有慢性疾病数量和参加周期数量后，6MWD 从基线的变化百分比与 WC 变化的百分比显著相关（系数：-1.33，95%CI：-2.42 至 -0.24）。