Department of Pediatrics, USC Keck School of Medicine, Los Angeles, CA, USA.
Department of Psychology, USC Dornsife Center for Economic and Social Research, Los Angeles, CA, USA.
J Altern Complement Med. 2021 Sep;27(9):738-749. doi: 10.1089/acm.2020.0515. Epub 2021 May 25.
To determine the effects of a novel lifestyle intervention combining lifestyle behavioral education with the complementary-integrative health modality of guided imagery (GI) on dietary and physical activity behaviors in adolescents. The primary aim of this study was to determine the incremental effects of the lifestyle education, stress reduction GI (SRGI), and lifestyle behavior GI (LBGI) components of the intervention on the primary outcome of physical activity lifestyle behaviors (sedentary behavior, light, moderate, and vigorous physical activity), as well as dietary intake behaviors, at the completion of the 12-week intervention. The authors hypothesized that the intervention would improve obesity-related lifestyle behaviors. Two hundred and thirty-two adolescent participants (aged 14-17 years, sophomore or junior year of high school) were cluster randomized by school into one of four intervention arms: nonintervention Control (C), Lifestyle education (LS), SRGI, and LBGI. After-school intervention sessions were held two (LS) or three (SRGI, LBGI) times weekly for 12 weeks. Physical activity (accelerometry) and dietary intake (multiple diet recalls) outcomes were assessed pre- and postintervention. Primary analysis: intention-to-treat (ITT) mixed-effects modeling with diagonal covariance matrices; secondary analysis: subgroup sensitivity analysis using only those participants adherent to protocol. ITT analysis showed that the Healthy Eating Index (HEI) increased in the LS group compared with C ( = 0.02), but there was no additional effect of GI. Among adherent participants, sedentary behavior was decreased stepwise relative to C in SRGI ( = -0.73, = 0.004) > LBGI ( = -0.59, = 0.04) > LS ( = -0.41, = 0.07), and moderate + vigorous physical activity was increased in SRGI ( = 0.58, = 0.001). Among adherent participants, the HEI was increased in LS and SRGI, and glycemic index reduced in LBGI. While ITT analysis was negative, among adherent participants, the Imagine HEALTH lifestyle intervention improved eating habits, reduced sedentary activity, and increased physical activity, suggesting that GI may amplify the role of lifestyle education alone for some key outcomes. Clinical Trials.gov ID: NCT02088294.
为了确定将生活方式行为教育与引导意象（GI）的补充综合健康模式相结合的新型生活方式干预对青少年饮食和体育活动行为的影响。本研究的主要目的是确定生活方式教育、应激减轻 GI（SRGI）和生活方式行为 GI（LBGI）干预成分对主要结果的增量影响，主要结果是体育活动生活方式行为（久坐行为、轻度、中度和剧烈体育活动），以及饮食摄入行为，在 12 周干预结束时。作者假设干预将改善与肥胖相关的生活方式行为。232 名青少年参与者（年龄 14-17 岁，高中二年级或三年级）按学校分为四组干预组之一：非干预对照组（C）、生活方式教育（LS）、SRGI 和 LBGI。每周两次（LS）或三次（SRGI、LBGI）在课后进行干预，共 12 周。在干预前后评估体育活动（加速度计）和饮食摄入（多次饮食回忆）结果。主要分析：意向治疗（ITT）混合效应模型与对角线协方差矩阵；次要分析：仅使用符合方案的参与者的亚组敏感性分析。ITT 分析表明，与 C 相比，LS 组的健康饮食指数（HEI）增加（ = 0.02），但 GI 没有额外的效果。在依从性参与者中，与 C 相比，SRGI 中久坐行为逐渐减少（ = -0.73， = 0.004）> LBGI（ = -0.59， = 0.04）> LS（ = -0.41， = 0.07），中度+剧烈体力活动在 SRGI 中增加（ = 0.58， = 0.001）。在依从性参与者中，LS 和 SRGI 中 HEI 增加，LBGI 中血糖指数降低。虽然 ITT 分析为阴性，但在依从性参与者中，想象健康生活方式干预改善了饮食习惯，减少了久坐活动，增加了体力活动，这表明 GI 可能会放大单独进行生活方式教育的作用对于某些关键结果。临床试验.gov ID：NCT02088294。
