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减少久坐、增加活动量以改善 2 型糖尿病患者的代谢和大脑健康:“优化健康”试验方案。

Sitting less and moving more for improved metabolic and brain health in type 2 diabetes: 'OPTIMISE your health' trial protocol.

机构信息

Baker Heart & Diabetes Institute, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.

Australian Catholic University, Mary Mackillop Institute of Health Research, Melbourne, Australia.

出版信息

BMC Public Health. 2022 May 10;22(1):929. doi: 10.1186/s12889-022-13123-x.

Abstract

BACKGROUND

Clinical practice guidelines recommend that adults with type 2 diabetes (T2D) sit less and move more throughout the day. The 18-month OPTIMISE Your Health Clinical Trial was developed to support desk-based workers with T2D achieve these recommendations. The two-arm protocol consists of an intervention and control arms. The intervention arm receives 6 months health coaching, a sit-stand desktop workstation and an activity tracker, followed by 6 months of text message support, then 6 months maintenance. The control arm receives a delayed modified intervention after 12 months of usual care. This paper describes the methods of a randomised controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of the intervention, compared to a delayed intervention control.

METHODS

This is a two-arm RCT being conducted in Melbourne, Australia. Desk-based workers (≥0.8 full-time equivalent) aged 35-65 years, ambulatory, and with T2D and managed glycaemic control (6.5-10.0% HbA1c), are randomised to the multicomponent intervention (target n = 125) or delayed-intervention control (target n = 125) conditions. All intervention participants receive 6 months of tailored health coaching assisting them to "sit less" and "move more" at work and throughout the day, supported by a sit-stand desktop workstation and an activity tracker (Fitbit). Participants receive text message-based extended care for a further 6-months (6-12 months) followed by 6-months of non-contact (12-18 months: maintenance). Delayed intervention occurs at 12-18 months for the control arm. Assessments are undertaken at baseline, 3, 6, 12, 15 and 18-months. Primary outcomes are activPAL-measured sitting time (h/16 h day), glycosylated haemoglobin (HbA1c; %, mmol/mol) and, cognitive function measures (visual learning and new memory; Paired Associates Learning Total Errors [adjusted]). Secondary, exploratory, and process outcomes will also be collected throughout the trial.

DISCUSSION

The OPTIMISE Your Health trial will provide unique insights into the benefits of an intervention aimed at sitting less and moving more in desk-bound office workers with T2D, with outcomes relevant to glycaemic control, and to cardiometabolic and brain health. Findings will contribute new insights to add to the evidence base on initiating and maintaining behaviour change with clinical populations and inform practice in diabetes management.

TRIAL REGISTRATION

ANZCTRN12618001159246 .

摘要

背景

临床实践指南建议 2 型糖尿病(T2D)患者全天减少久坐、增加活动。为期 18 个月的 OPTIMISE Your Health 临床试验旨在帮助 T2D 的久坐型上班族达到这些建议。该双臂方案包括干预组和对照组。干预组接受 6 个月的健康指导、可坐立的台式工作站和活动追踪器,然后是 6 个月的短信支持,最后是 6 个月的维持期。对照组在接受 12 个月的常规护理后接受延迟的改良干预。本文介绍了一项随机对照试验(RCT)的方法,评估与延迟干预对照组相比,该干预措施的有效性和成本效益。

方法

这是一项在澳大利亚墨尔本进行的双臂 RCT。年龄在 35-65 岁、有活动能力且糖化血红蛋白控制良好(6.5-10.0%HbA1c)的久坐型上班族(全职等效≥0.8 人)被随机分配至多组分干预组(目标人数 125 人)或延迟干预对照组(目标人数 125 人)。所有干预组参与者接受 6 个月的量身定制的健康指导,帮助他们在工作和日常生活中“减少久坐”和“增加活动”,同时提供可坐立的台式工作站和活动追踪器(Fitbit)。参与者还将接受为期 6 个月的短信扩展护理(6-12 个月),然后是 6 个月的非接触护理(12-18 个月:维持期)。对照组在 12-18 个月时接受延迟干预。评估在基线、3、6、12、15 和 18 个月时进行。主要结局指标是 activPAL 测量的久坐时间(每 16 小时的小时数)、糖化血红蛋白(HbA1c;%,mmol/mol)和认知功能测量(视觉学习和新记忆;配对联想学习总错误[校正])。整个试验还将收集次要、探索性和过程性结局。

讨论

OPTIMISE Your Health 试验将提供独特的见解,了解针对 T2D 久坐型上班族减少久坐和增加活动的干预措施的益处,其结果与血糖控制以及心脏代谢和大脑健康相关。研究结果将为临床人群启动和维持行为改变的证据基础提供新的见解,并为糖尿病管理实践提供信息。

试验注册

ANZCTRN12618001159246。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ea7/9088032/ae3ae63e8146/12889_2022_13123_Fig1_HTML.jpg

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