利用健康信息技术在备孕期间让非裔美国女性关注营养和补充剂的使用。
Using Health Information Technology to Engage African American Women on Nutrition and Supplement Use During the Preconception Period.
机构信息
Department of Family Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
Khoury College of Computer Sciences, Northeastern University, Boston, MA, United States.
出版信息
Front Endocrinol (Lausanne). 2021 Jan 19;11:571705. doi: 10.3389/fendo.2020.571705. eCollection 2020.
IMPORTANCE
Healthy nutrition and appropriate supplementation during preconception have important implications for the health of the mother and newborn. The best way to deliver preconception care to address health risks related to nutrition is unknown.
METHODS
We conducted a secondary analysis of data from a randomized controlled trial designed to study the impact of conversational agent technology in 13 domains of preconception care among 528 non-pregnant African American and Black women. This analysis is restricted to those 480 women who reported at least one of the ten risks related to nutrition and dietary supplement use.
INTERVENTIONS
An online conversational agent, called "Gabby", assesses health risks and delivers 12 months of tailored dialogue for over 100 preconception health risks, including ten nutrition and supplement risks, using behavioral change techniques like shared decision making and motivational interviewing. The control group received a letter listing their preconception risks and encouraging them to talk to a health care provider.
RESULTS
After 6 months, women using Gabby (a) reported progressing forward on the stage of change scale for, on average, 52.9% (SD, 35.1%) of nutrition and supplement risks compared to 42.9% (SD, 35.4) in the control group (IRR 1.22, 95% CI 1.03-1.45, P = 0.019); and (b) reported achieving the action and maintenance stage of change for, on average, 52.8% (SD 37.1) of the nutrition and supplement risks compared to 42.8% (SD, 37.9) in the control group (IRR 1.26, 96% CI 1.08-1.48, P = 0.004). For subjects beginning the study at the contemplation stage of change, intervention subjects reported progressing forward on the stage of change scale for 75.0% (SD, 36.3%) of their health risks compared to 52.1% (SD, 47.1%) in the control group (P = 0.006).
CONCLUSION
The scalability of Gabby has the potential to improve women's nutritional health as an adjunct to clinical care or at the population health level. Further studies are needed to determine if improving nutrition and supplement risks can impact clinical outcomes including optimization of weight.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier NCT01827215.
重要性
健康的营养和适当的补充在受孕前对母亲和新生儿的健康有重要影响。为了解决与营养相关的健康风险，提供受孕前护理的最佳方法尚不清楚。
方法
我们对一项随机对照试验的数据进行了二次分析，该试验旨在研究对话代理技术在 528 名非怀孕的非裔美国人和黑种女性的 13 个受孕前护理领域的影响。本分析仅限于那些报告至少存在 10 种与营养和膳食补充剂使用相关的风险的 480 名女性。
干预措施
一个名为“Gabby”的在线对话代理评估健康风险，并提供 12 个月的个性化对话，针对 100 多个受孕前健康风险，包括 10 种营养和补充剂风险，使用行为改变技术，如共同决策和动机访谈。对照组收到了一份列出他们受孕前风险的信，并鼓励他们与医疗保健提供者交谈。
结果
6 个月后，使用 Gabby 的女性（a）报告说，与对照组相比，她们在营养和补充剂风险的平均 52.9%（标准差 35.1%）进入了改变阶段的进展阶段，而对照组为 42.9%（标准差 35.4%）（IRR 1.22，95%CI 1.03-1.45，P=0.019）；（b）报告说，她们在营养和补充剂风险的平均 52.8%（标准差 37.1）进入了行动和维持阶段的改变，而对照组为 42.8%（标准差 37.9）（IRR 1.26，96%CI 1.08-1.48，P=0.004）。对于从改变阶段的思考阶段开始研究的受试者，干预组报告说，她们在 75.0%（标准差 36.3%）的健康风险中进入了改变阶段的进展阶段，而对照组为 52.1%（标准差 47.1%）（P=0.006）。
结论
Gabby 的可扩展性有可能改善妇女的营养健康，作为临床护理的辅助手段或在人群健康水平上。需要进一步的研究来确定改善营养和补充剂风险是否可以影响临床结果，包括体重的优化。
临床试验注册
ClinicalTrials.gov，标识符 NCT01827215。
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