DiPietro Loretta, Bingenheimer Jeffrey, Talegawkar Sameera A, Sedlander Erica, Yilma Hagere, Pradhan Pratima, Rimal Rajiv
Departments of Exercise & Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Departments of Prevention & Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
BMC Public Health. 2021 Apr 15;21(1):735. doi: 10.1186/s12889-021-10785-x.
The negative impact of anemia on work capacity has been studied extensively in male and female workers; however, the simultaneous contributions of confounding variables such as physical activity, as well as other behavioral and sociodemographic characteristics have not been considered. The purpose of this study was to examine cross-sectionally the multivariable correlates of work capacity in non-pregnant women (n = 330) living in rural India.
The Reduction in Anemia through Normative Innovations (RANI) Project is a norms-based, clustered randomized controlled trial to reduce anemia among women (15-49 years) living in Odisha, India between 2018 and 2021. For the larger trial, 89 clusters of villages were randomized into treatment and control groups on a 1:1 basis. Women (2055/group) living in 15 selected clusters (40-41 villages) were then randomly selected for data collection. The sampling design also randomly-generated a subset (n = 375) of non-pregnant participants who performed a modified Queen's College Step Test (QCST) and who wore an activity monitor for 3 days. Predicted work capacity (VO) was determined using the QCST. Levels (h/day) of daily reclining, sitting, standing, walking (steps/day), and energy expenditure (MET∙h/day) were determined using an ActivPAL accelerometer. Hemoglobin concentrations (g/dL) were determined using a HemoCue photometer. Predetermined hierarchical (non-multilevel) regression models tested the independent associations between the primary study variables of interest (physical activity, hemoglobin concentrations) and predicted VO, while adjusting for age, body mass index (BMI: kg/m), education, parity, and dietary diversity score.
Approximately 61% of the participants had anemia (Hb < 12 g/dL). Age (β = - 0.01; 95% CI: - 0.01, 0.00), BMI (β = - 0.19; 95% CI:-0.28, - 0.09), educational attainment (β = - 1.35; 95% CI: - 2.34, - 0.36), and MET∙h/day (β = 0.19; 95% CI: 0.00, 0.38) were significant and independent determinants of work capacity. Hemoglobin concentration was marginally associated with work capacity in the presence of the other covariables (β = 0.22; 95% CI:-0.02, 0.47).
Our data indicate that factors other than anemia are important correlates of work capacity and should be considered when promoting the health and economic capacity of rural Indian women.
Clinical Trial Registry- India (CTRI) http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=26285&EncHid=&userName=CTRI/2018/10/016186 on 29 October 2018.
贫血对男性和女性劳动者工作能力的负面影响已得到广泛研究；然而，尚未考虑诸如体力活动等混杂变量以及其他行为和社会人口学特征的综合影响。本研究的目的是对生活在印度农村的非妊娠女性（n = 330）的工作能力多变量相关性进行横断面研究。
通过规范创新减少贫血（RANI）项目是一项基于规范的整群随机对照试验，旨在减少2018年至2021年期间生活在印度奥里萨邦的15至49岁女性的贫血情况。对于规模更大的试验，89个村庄群按1:1的比例随机分为治疗组和对照组。然后从15个选定的群（40 - 41个村庄）中随机选取女性（每组2055人）进行数据收集。抽样设计还随机生成了一个非妊娠参与者子集（n = 375），这些参与者进行了改良的女王学院阶梯试验（QCST），并佩戴活动监测器3天。使用QCST确定预测工作能力（VO）。使用ActivPAL加速度计确定每日躺卧、坐着、站立、行走（步数/天）的时长（小时/天）以及能量消耗（MET∙小时/天）。使用HemoCue光度计测定血红蛋白浓度（克/分升）。预定的分层（非多层次）回归模型在调整年龄、体重指数（BMI：千克/米²）、教育程度、产次和饮食多样性评分的同时，检验了主要研究变量（体力活动、血红蛋白浓度）与预测VO之间的独立关联。
约61% 的参与者患有贫血（血红蛋白<12克/分升）。年龄（β = -0.01；95%CI：-0.01，0.00）、BMI（β = -0.19；95%CI：-0.28，-0.09）、教育程度（β = -1.35；95%CI：-2.34，-0.36）和MET∙小时/天（β = 0.19；95%CI：0.00，0.38）是工作能力的显著且独立的决定因素。在存在其他协变量的情况下，血红蛋白浓度与工作能力存在微弱关联（β = 0.22；95%CI：-0.02，0.47）。
我们的数据表明，除贫血外的其他因素是工作能力的重要相关因素，在促进印度农村女性的健康和经济能力时应予以考虑。
印度临床试验注册中心（CTRI）http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=26285&EncHid=&userName=CTRI/2018/10/016186，于2018年10月29日注册。
