Lo Brian K, Graham Meredith L, Eldridge Galen, Donoso Maria R, Folta Sara C, Strogatz David, Nelson Miriam E, Paul Lynn C, Parry Stephen A, Seguin-Fowler Rebecca A
Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA.
Texas A&M AgriLife Research, Texas A&M University, College Station, Texas, USA.
Obesity (Silver Spring). 2020 Jul;28(7):1224-1234. doi: 10.1002/oby.22817. Epub 2020 May 22.
This study aimed to examine (1) whether the Strong Hearts, Healthy Communities intervention (SHHC) improved social network members' (SNMs') weight, exercise, and diet and (2) whether SNMs' weight and behavioral changes were modified by their relationship closeness and/or spatial closeness with trial participants.
Eight towns received the SHHC intervention, which focused on building individual healthy behaviors and creating supportive social and built environments for exercise and healthy eating. Eight towns received an education-only control intervention. SNMs (n = 487) were recruited to complete a questionnaire at baseline and at 6 months that asked about demographics, weight, height, exercise, and eating habits.
SHHC's effect on SNMs differed depending on their relationship closeness with trial participants. Among SNMs who had a very close relationship with trial participants, those associated with the intervention group lost more weight and decreased BMI more than those associated with the control group (weight [kilograms] between-group difference: Δ = -1.68; 95% CI: -3.10 to -0.25; P = 0.021; BMI between-group difference: Δ = -0.60; 95% CI: -1.16 to -0.04; P = 0.034). Spatial closeness did not modify any of SHHC's ripple effects.
Relationship closeness, rather than spatial closeness, played an important role in influencing a rural community-based intervention's ripple effects.
本研究旨在探讨：（1）“强心，健康社区”干预措施（SHHC）是否改善了社交网络成员（SNMs）的体重、锻炼和饮食；（2）SNMs的体重和行为变化是否因其与试验参与者的关系亲密度和/或空间距离而有所改变。
八个城镇接受了SHHC干预，该干预侧重于培养个人健康行为，并为锻炼和健康饮食营造支持性的社会及环境。八个城镇接受了仅提供教育的对照干预。招募SNMs（n = 487）在基线时和6个月时完成一份问卷，问卷询问了人口统计学信息、体重、身高、锻炼和饮食习惯。
SHHC对SNMs的影响因其与试验参与者的关系亲密度而异。在与试验参与者关系非常密切的SNMs中，与干预组相关的人比与对照组相关的人减重更多，BMI降低更多（体重[千克]组间差异：Δ = -1.68；95% CI：-3.10至-0.25；P = 0.021；BMI组间差异：Δ = -0.60；95% CI：-1.16至-0.04；P = 0.034）。空间距离并未改变SHHC的任何涟漪效应。
关系亲密度而非空间距离在影响基于农村社区的干预措施的涟漪效应方面发挥了重要作用。
