School of Nursing and Midwifery, Griffith University, Queensland, Australia.
Menzies Health Institute of Queensland, Griffith University, Queensland, Australia.
BMC Public Health. 2022 Aug 30;22(1):1648. doi: 10.1186/s12889-022-14056-1.
Chronic disease is the leading cause of premature death globally, and many of these deaths are preventable by modifying some key behavioural and metabolic risk factors. This study examines changes in health behaviours among men and women at risk of diabetes or cardiovascular disease (CVD) who participated in a 6-month lifestyle intervention called the My health for life program.
The My health for life program is a Queensland Government-funded multi-component program designed to reduce chronic disease risk factors amongst at-risk adults in Queensland, Australia. The intervention comprises six sessions over a 6-month period, delivered by a trained facilitator or telephone health coach. The analysis presented in this paper stems from 9,372 participants who participated in the program between July 2017 and December 2019. Primary outcomes included fruit and vegetable intake, consumption of sugar-sweetened drinks and take-away, alcohol consumption, tobacco smoking, and physical activity. Variables were summed to form a single Healthy Lifestyle Index (HLI) ranging from 0 to 13, with higher scores denoting healthier behaviours. Longitudinal associations between lifestyle indices, program characteristics and socio-demographic characteristics were assessed using Gaussian Generalized Estimating Equations (GEE) models with an identity link and robust standard errors.
Improvements in HLI scores were noted between baseline (Md = 8.8; IQR = 7.0, 10.0) and 26-weeks (Md = 10.0; IQR = 9.0, 11.0) which corresponded with increases in fruit and vegetable consumption and decreases in takeaway frequency (p < .001 for all) but not risky alcohol intake. Modelling showed higher average HLI among those aged 45 or older (β = 1.00, 95% CI = 0.90, 1.10, p < .001) with vocational educational qualifications (certificate/diploma: β = 0.32, 95% CI = 0.14, 0.50, p < .001; bachelor/post-graduate degree β = 0.79, 95% CI = 0.61, 0.98, p < .001) while being male, Aboriginal or Torres Strait Islander background, or not currently working conferred lower average HLI scores (p < .001 for all).
While participants showed improvements in dietary indicators, changes in alcohol consumption and physical activity were less amenable to the program. Additional research is needed to help understand the multi-level barriers and facilitators of behaviour change in this context to further tailor the intervention for priority groups.
慢性病是导致全球人口过早死亡的主要原因，而通过改变一些关键的行为和代谢风险因素，许多此类死亡是可以预防的。本研究调查了参加名为“我的健康生活”（My health for life）计划的有糖尿病或心血管疾病（CVD）风险的男性和女性在 6 个月的生活方式干预后健康行为的变化。
“我的健康生活”计划是昆士兰州政府资助的多组分计划，旨在降低澳大利亚昆士兰州高危成年人的慢性疾病风险因素。该干预措施包括在 6 个月期间进行 6 次会议，由经过培训的主持人或电话健康教练提供。本文介绍的分析基于 2017 年 7 月至 2019 年 12 月期间参加该计划的 9372 名参与者。主要结果包括水果和蔬菜摄入量、糖饮料和外卖食品的消费、饮酒量、吸烟量和身体活动量。变量被加总形成一个健康生活方式指数（HLI），范围从 0 到 13，得分越高表示行为越健康。使用具有恒等链接和稳健标准误差的高斯广义估计方程（GEE）模型评估生活方式指数、计划特征和社会人口统计学特征之间的纵向关联。
与基线相比（Md=8.8；IQR=7.0，10.0），26 周时 HLI 评分有所提高（Md=10.0；IQR=9.0，11.0），这与水果和蔬菜摄入量的增加以及外卖频率的降低相对应（所有 p 值均<.001），但风险饮酒量没有变化。模型显示，年龄在 45 岁或以上（β=1.00，95%CI=0.90，1.10，p<.001）、具有职业教育资格（证书/文凭：β=0.32，95%CI=0.14，0.50，p<.001；学士/研究生学位：β=0.79，95%CI=0.61，0.98，p<.001）的人平均 HLI 更高，而男性、原住民或托雷斯海峡岛民背景或目前没有工作的人平均 HLI 较低（所有 p 值均<.001）。
尽管参与者在饮食指标上有所改善，但酒精消费和身体活动的变化对该计划的适应性较差。需要进一步研究，以帮助了解这种情况下行为改变的多层次障碍和促进因素，从而进一步为重点人群调整干预措施。
