生活方式辅导（CooL）干预的实施：经验教训。
The implementation of the coaching on lifestyle (CooL) intervention: lessons learnt.
机构信息
Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Faculty of Sciences and Engineering, University College Venlo, Maastricht University, P.O. Box 8, 5900, AA, Venlo, The Netherlands.
出版信息
BMC Health Serv Res. 2019 Sep 14;19(1):667. doi: 10.1186/s12913-019-4457-7.
BACKGROUND
Combined lifestyle interventions (CLIs) are designed to help people who are overweight or obese maintain a healthy new lifestyle. The CooL intervention is a CLI in the Netherlands, in which lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The intervention consists of coaching on lifestyle in group and individual sessions, addressing the topics of physical activity, dietary behaviours, sleep, stress management and behavioural change. The aim of this study was to evaluate the implementation process of the Coaching on Lifestyle (CooL) intervention and its facilitating and impeding factors.
METHODS
Mixed methods were used in this action-oriented study. Both quantitative (number of referrals, attendance lists of participants and questionnaires) and qualitative (group and individual interviews, observations, minutes and open questions) data were collected among participants, lifestyle coaches, project group members and other stakeholders. The Consolidated Framework for Implementation Research was used to analyse the data.
RESULTS
CooL was evaluated by stakeholders and participants as an accessible and useful programme, because of its design and content and the lifestyle coaches' approach. However, stakeholders indicated that the lifestyle coaches need to become more familiar in the health care network and public sectors in the Netherlands. Lifestyle coaching is a novel profession and the added value of the lifestyle coach is not always acknowledged by all health care providers. Lifestyle coaches play a crucial role in ensuring the impact of CooL by actively networking, using clear communication materials and creating stakeholders' support and understanding.
CONCLUSION
The implementation process needs to be strengthened in terms of creating support for and providing clear information about lifestyle coaching. The CooL intervention was implemented in multiple regions, thanks to the efforts of many stakeholders. Lifestyle coaches should engage in networking activities and entrepreneurship to boost the implementation process. It takes considerable time for a lifestyle coach to become fully incorporated in primary care.
TRIAL REGISTRATION
NTR6208 ; date registered: 13-01-2017; retrospectively registered; Netherlands Trial Register.
背景
联合生活方式干预（CLIs）旨在帮助超重或肥胖的人保持健康的新生活方式。CooL 干预是荷兰的一种 CLI，其中生活方式教练为肥胖或有肥胖风险的成年人和儿童（和/或其父母）提供咨询，以实现持续更健康的生活方式。该干预措施包括在小组和个别会议上进行生活方式指导，涉及体育活动、饮食行为、睡眠、压力管理和行为改变等主题。本研究旨在评估生活方式指导（CooL）干预的实施过程及其促进和阻碍因素。
方法
本行动导向研究采用混合方法。参与者、生活方式教练、项目组成员和其他利益相关者收集了定量（转诊人数、参与者出席名单和问卷）和定性（小组和个人访谈、观察、记录和开放式问题）数据。使用实施研究综合框架分析数据。
结果
利益相关者和参与者评估 CooL 是一个易于访问且有用的项目，因为其设计和内容以及生活方式教练的方法。然而，利益相关者表示，生活方式教练需要在荷兰的医疗保健网络和公共部门中更加熟悉。生活方式教练是一个新的职业，并非所有医疗保健提供者都认可生活方式教练的附加值。生活方式教练通过积极建立网络、使用清晰的沟通材料以及为利益相关者提供支持和理解，在确保 CooL 的影响方面发挥着至关重要的作用。
结论
在创造对生活方式指导的支持和提供有关生活方式指导的明确信息方面，实施过程需要加强。由于许多利益相关者的努力，CooL 干预措施在多个地区得到实施。生活方式教练应开展网络活动和创业活动，以推动实施过程。生活方式教练需要相当长的时间才能完全融入初级保健。
试验注册
NTR6208；注册日期：2017 年 1 月 13 日；回顾性注册；荷兰试验注册处。
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