Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK.
NIHR Applied Research Collaboration - East Midlands, Leicester, UK.
BMC Med. 2021 Jun 3;19(1):130. doi: 10.1186/s12916-021-01997-4.
Physical activity is associated with a reduced risk of type 2 diabetes and cardiovascular disease but limited evidence exists for the sustained promotion of increased physical activity within diabetes prevention trials. The aim of the study was to investigate the long-term effectiveness of the Walking Away programme, an established group-based behavioural physical activity intervention with pedometer use, when delivered alone or with a supporting mHealth intervention.
Those at risk of diabetes (nondiabetic hyperglycaemia) were recruited from primary care, 2013-2015, and randomised to (1) Control (information leaflet); (2) Walking Away (WA), a structured group education session followed by annual group-based support; or (3) Walking Away Plus (WAP), comprising WA annual group-based support and an mHealth intervention delivering tailored text messages supported by telephone calls. Follow-up was conducted at 12 and 48 months. The primary outcome was accelerometer measured ambulatory activity (steps/day). Change in primary outcome was analysed using analysis of covariance with adjustment for baseline, randomisation and stratification variables.
One thousand three hundred sixty-six individuals were randomised (median age = 61 years, ambulatory activity = 6638 steps/day, women = 49%, ethnic minorities = 28%). Accelerometer data were available for 1017 (74%) individuals at 12 months and 993 (73%) at 48 months. At 12 months, WAP increased their ambulatory activity by 547 (97.5% CI 211, 882) steps/day compared to control and were 1.61 (97.5% CI 1.05, 2.45) times more likely to achieve 150 min/week of moderate-to-vigorous physical activity. Differences were not maintained at 48 months. WA was no different to control at 12 or 48 months. Secondary anthropometric and health outcomes were largely unaltered in both intervention groups apart from small reductions in body weight in WA (~ 1 kg) at 12- and 48-month follow-up.
Combining a pragmatic group-based intervention with text messaging and telephone support resulted in modest changes to physical activity at 12 months, but changes were not maintained at 48 months.
ISRCTN 83465245 (registered on 14 June 2012).
身体活动与 2 型糖尿病和心血管疾病风险降低有关，但在糖尿病预防试验中，身体活动的持续增加的促进作用的证据有限。本研究的目的是调查已建立的基于小组的行为身体活动干预措施（使用计步器）的Walking Away 计划的长期效果，该计划单独或与支持移动健康的干预措施一起使用。
2013 年至 2015 年，从初级保健中招募了有患糖尿病风险的人群（非糖尿病性高血糖），并将其随机分为（1）对照组（信息传单）；（2）Walking Away（WA），即接受结构化小组教育课程，然后每年接受小组支持；或（3）Walking Away Plus（WAP），包括 WA 每年的小组支持和通过电话提供个性化短信的移动健康干预措施。在 12 个月和 48 个月时进行随访。主要结局是通过加速度计测量的活动量（每日步数）。使用协方差分析，根据基线、随机化和分层变量进行调整，对主要结局的变化进行分析。
共有 1366 人被随机分组（中位年龄=61 岁，活动量=6638 步/天，女性=49%，少数民族=28%）。12 个月时，1017 名（74%）参与者和 48 个月时，993 名（73%）参与者提供了加速度计数据。在 12 个月时，与对照组相比，WAP 使他们的活动量增加了 547 步/天（97.5%CI211，882），并且他们更有可能每周进行 150 分钟中等至剧烈强度的身体活动，比例为 1.61（97.5%CI1.05，2.45）。这些差异在 48 个月时没有维持。WA 在 12 个月和 48 个月时与对照组无差异。除了 WA 在 12-和 48 个月随访时体重略有减轻（~1kg）外，两个干预组的次要人体测量和健康结局基本保持不变。
将基于小组的实用干预措施与短信和电话支持相结合，在 12 个月时使身体活动发生适度变化，但在 48 个月时这些变化并未持续。
ISRCTN83465245（2012 年 6 月 14 日注册）。
