基于技术的农村肥胖老年人体重管理干预的可行性和可接受性。
Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity.
机构信息
Division of Geriatric Medicine, School of Medicine, and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 5017 Old Clinic Building, Chapel Hill, NC, 27599, USA.
Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA.
出版信息
BMC Geriatr. 2021 Jan 12;21(1):44. doi: 10.1186/s12877-020-01978-x.
BACKGROUND
Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology.
METHODS
A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing to participants in their homes. Participants used a Fitbit Alta HR for remote monitoring with data feedback provided by the interventionists. An aerobic activity prescription was provided and monitored.
RESULTS
Mean age was 72.9±3.9 years (82% female). Baseline anthropometric measures of weight, BMI, and waist circumference were 97.8±16.3 kg, 36.5±5.2 kg/m, and 115.5±13.0 cm, respectively. A total of 142 participants were screened (n=27 ineligible), and 53 consented. There were nine dropouts (17%). Overall satisfaction with the trial (4.7+ 0.6, scale: 1 (low) to 5 (high)) and with Fitbit (4.2+ 0.9) were high. Fitbit was worn an average of 81.7±19.3% of intervention days. In completers, mean weight loss was 4.6±3.5 kg or 4.7±3.5% (p< 0.001). Physical function measures of 30-s sit-to-stand repetitions increased from 13.5±5.7 to 16.7±5.9 (p< 0.001), 6-min walk improved by 42.0±77.3 m (p=0.005) but no differences were observed in gait speed or grip strength. Subjective measures of late-life function improved (3.4±4.7 points, p< 0.001).
CONCLUSIONS
A technology-based obesity intervention is feasible and acceptable to older adults with obesity and may lead to weight loss and improved physical function.
CLINICAL TRIAL REGISTRATION
Registered on Clinicaltrials.gov # NCT03104205 . Registered on April 7, 2017. First participant enrolled on October 1st, 2018.
背景
居住在农村地区的肥胖老年患者获得体重管理项目的机会较少。我们旨在确定一种基于远程监控和同步视频技术的综合技术健康促进干预措施在农村地区老年肥胖患者中的可行性、可接受性和初步效果。
方法
这是一项 2018 年 10 月至 2020 年 5 月期间在社区成人老龄化中心开展的 6 个月、非随机、非盲、单臂研究，纳入了年龄≥65 岁、体重指数（BMI）≥30kg/m²的肥胖患者。每周营养师进行一次行为疗法和热量限制咨询，每两周物理治疗师进行一次小组力量、柔韧性和平衡训练，参与者在家中通过视频会议接受服务。参与者使用 Fitbit Alta HR 进行远程监测，干预人员提供数据反馈。还提供了有氧运动处方并进行了监测。
结果
参与者的平均年龄为 72.9±3.9 岁（82%为女性）。基线时体重、BMI 和腰围的人体测量指标分别为 97.8±16.3kg、36.5±5.2kg/m²和 115.5±13.0cm。共有 142 名患者接受了筛查（27 名不合格），53 名同意参加。共有 9 名患者退出（17%）。总体而言，患者对试验（4.7+0.6，范围：1（低）至 5（高））和 Fitbit（4.2+0.9）的满意度很高。Fitbit 的佩戴率平均为干预天数的 81.7±19.3%。在完成者中，平均体重减轻 4.6±3.5kg 或 4.7±3.5%（p<0.001）。30 秒坐站重复次数等身体功能指标从 13.5±5.7 增加到 16.7±5.9（p<0.001），6 分钟步行距离增加了 42.0±77.3m（p=0.005），但步态速度或握力没有差异。晚年功能的主观指标得到改善（3.4±4.7 分，p<0.001）。
结论
基于技术的肥胖干预措施对肥胖的老年患者是可行且可接受的，可能会导致体重减轻和身体功能改善。
临床试验注册
ClinicalTrials.gov 注册 # NCT03104205 。于 2017 年 4 月 7 日注册。第一位参与者于 2018 年 10 月 1 日入组。
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