在线减肥计划对情绪低落男性的行为和认知结果：一项随机对照试验。

Behavioral and Cognitive Outcomes of an Online Weight Loss Program for Men With Low Mood: A Randomized Controlled Trial.

机构信息

Priority Research Centre for Physical Activity and Nutrition, School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, New South Wales, Australia.

Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.

出版信息

Ann Behav Med. 2022 Oct 3;56(10):1026-1041. doi: 10.1093/abm/kaab109.

DOI:10.1093/abm/kaab109

PMID:34964449

Abstract

BACKGROUND

Depression and obesity are major health concerns and commonly co-exist, but men rarely seek help for these conditions. SHED-IT: Recharge was a gender-tailored eHealth program for men that generated clinically meaningful improvements in weight and depressive symptoms.

PURPOSE

To evaluate behavioral and psychological outcomes from the SHED-IT: Recharge intervention designed for overweight/obese men with low mood.

METHODS

Overall, 125 men (18-70 years) with a BMI between 25 and 42 kg/m2 and depressive symptoms (PHQ-9 ≥ 5) were randomly allocated to SHED-IT: Recharge (n = 62) or wait-list control (n = 63) groups. The self-directed program targeted key health behaviors combined with online mental fitness modules based on cognitive behavioral therapy. Behavioral (e.g., physical activity) and psychological outcomes (e.g., cognitive flexibility) were assessed with validated measures at baseline, 3 months (post-test) and 6 months (follow-up). Intention-to-treat linear mixed models examined treatment effects, which were adjusted for covariates, and effect size estimated (Cohen's d).

RESULTS

At post-test, intervention men achieved small-to-medium improvements in several health behavior outcomes including moderate-to-vigorous physical activity, light physical activity, sedentary behavior, sleep, energy intake, portion size, and risky alcohol consumption (range, d = 0.3-0.5), when compared with the control group. Intervention effects were also observed for perceived physical self-worth, perceived physical strength, cognitive flexibility, and behavioral activation (range, d = 0.3-0.8). No effects were found for fruit and vegetable intake, or mindful attention. Most effects were maintained at follow-up.

CONCLUSIONS

This gender-tailored, eHealth program with integrated mental fitness support elicited meaningful improvements in health behaviors and psychological outcomes for men with low mood. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12619001209189).

摘要

背景

抑郁和肥胖是两个主要的健康问题，而且通常同时存在，但男性很少寻求这些问题的帮助。SHED-IT：Recharge 是一个针对男性的性别化电子健康计划，可在体重和抑郁症状方面产生有临床意义的改善。

目的

评估为情绪低落的超重/肥胖男性设计的 SHED-IT：Recharge 干预措施在行为和心理结果方面的效果。

方法

共有 125 名 BMI 在 25 至 42 kg/m2 之间且有抑郁症状（PHQ-9≥5）的男性（18-70 岁）被随机分配到 SHED-IT：Recharge（n=62）或候补名单对照组（n=63）。该自我指导计划针对关键健康行为，并结合基于认知行为疗法的在线心理适应模块。在基线、3 个月（后测）和 6 个月（随访）时，使用经过验证的测量工具评估行为（如身体活动）和心理结果（如认知灵活性）。意向性治疗线性混合模型检查了治疗效果，该效果针对协变量进行了调整，并估计了效应大小（Cohen's d）。

结果

在后测时，与对照组相比，干预组男性在多项健康行为结果方面取得了较小至中等程度的改善，包括中高强度身体活动、轻度身体活动、久坐行为、睡眠、能量摄入、份量大小和危险饮酒（范围，d=0.3-0.5）。干预效果还见于感知身体自我价值、感知身体力量、认知灵活性和行为激活（范围，d=0.3-0.8）。对于水果和蔬菜摄入量或正念注意力，未发现效果。大多数效果在随访时仍保持不变。