基于初级保健的电子健康生活方式教练计划的长期减肥效果：随机对照试验。
Long-term Weight Loss in a Primary Care-Anchored eHealth Lifestyle Coaching Program: Randomized Controlled Trial.
机构信息
Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Steno Diabetes Center Zealand, Holdbaek, Denmark.
出版信息
J Med Internet Res. 2022 Sep 23;24(9):e39741. doi: 10.2196/39741.
BACKGROUND
Long-term weight loss in people living with obesity can reduce the risk and progression of noncommunicable diseases. Observational studies suggest that digital coaching can lead to long-term weight loss.
OBJECTIVE
We investigated whether an eHealth lifestyle coaching program for people living with obesity with or without type 2 diabetes led to significant, long-term (12-month) weight loss compared to usual care.
METHODS
In a randomized controlled trial that took place in 50 municipalities in Denmark, 340 people living with obesity with or without type 2 diabetes were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (n=200) or a control (n=140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention consisted of an initial 1-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. The primary outcome was change in body weight from baseline to 12 months.
RESULTS
Data were assessed for 200 participants, including 127 from the intervention group and 73 from the control group, who completed 12 months of follow-up. After 12 months, mean body weight and BMI were significantly reduced in both groups but significantly more so in the intervention group than the control group (-4.5 kg, 95% CI -5.6 to -3.4 vs -1.5 kg, 95% CI -2.7 to -0.2, respectively; P<.001; and -1.5 kg/m, 95% CI -1.9 to -1.2 vs -0.5 kg/m, 95% CI -0.9 to -0.1, respectively; P<.001). Hemoglobin A was significantly reduced in both the intervention (-6.0 mmol/mol, 95% CI -7.7 to -4.3) and control (-4.9 mmol/mol, 95% CI -7.4 to -2.4) groups, without a significant group difference (all P>.46).
CONCLUSIONS
Compared to usual care, digital lifestyle coaching can induce significant weight loss for people living with obesity, both with and without type 2 diabetes, after 12 months.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03788915; https://clinicaltrials.gov/ct2/show/NCT03788915.
背景
肥胖人群的长期减重可以降低非传染性疾病的风险和进展。观察性研究表明，数字辅导可以带来长期的体重减轻。
目的
我们研究了针对肥胖人群（无论是否患有 2 型糖尿病）的电子健康生活方式辅导计划是否与常规护理相比，可导致显著的、长期（12 个月）的体重减轻。
方法
在一项于 2018 年 4 月 16 日至 2019 年 4 月 1 日在丹麦 50 个市进行的随机对照试验中，从全科医生、丹麦糖尿病组织和社交媒体招募了 340 名患有肥胖症（无论是否患有 2 型糖尿病）的患者，他们通过自动计算机算法随机分配到干预组（n=200）或对照组（n=140）。数字辅导干预包括初始的 1 小时面对面动机访谈，然后通过行为改变技术进行数字辅导，这些技术可通过个体实时监测来实现。主要结局指标是从基线到 12 个月的体重变化。
结果
共有 200 名参与者（干预组 127 名，对照组 73 名）完成了 12 个月的随访，对其数据进行了评估。12 个月后，两组的体重和 BMI 均显著降低，但干预组比对照组降低更为显著（-4.5kg，95%CI-5.6 至-3.4 比-1.5kg，95%CI-2.7 至-0.2，P<.001；-1.5kg/m，95%CI-1.9 至-1.2 比-0.5kg/m，95%CI-0.9 至-0.1，P<.001）。两组的血红蛋白 A 均显著降低（干预组-6.0mmol/mol，95%CI-7.7 至-4.3；对照组-4.9mmol/mol，95%CI-7.4 至-2.4），但两组间无显著差异（均 P>.46）。
结论
与常规护理相比，数字生活方式辅导可在 12 个月后使肥胖人群（无论是否患有 2 型糖尿病）显著减重。
试验注册
ClinicalTrials.gov NCT03788915；https://clinicaltrials.gov/ct2/show/NCT03788915。
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