“老年人成功生活的健康饮食™”社区教育项目——生活方式行为评估:一项随机对照试验。
Healthy Eating for Successful Living in Older Adults™ community education program-evaluation of lifestyle behaviors: A randomized controlled trial.
作者信息
Barnett Junaidah B, Zeng Wu
机构信息
Health and Healing Research Education and Service, Boston, MA, United States.
Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, MA, United States.
出版信息
Front Aging. 2022 Sep 6;3:960986. doi: 10.3389/fragi.2022.960986. eCollection 2022.
Older adults face many chronic health issues including heart disease and osteoporosis, which are preventable through changes in lifestyle behaviors. The Healthy Eating for Successful Living in Older Adults™ (HESL) is a 6-week community education program designed specifically for persons aged ≥60 years, to promote behavioral changes toward a healthy lifestyle. Our objective is to evaluate the HESL. This is the first official evaluation of the HESL since its initiation in 2005. A cluster randomized controlled trial. Program implementation and evaluation took place between July 2018 and January 2020. Twenty-nine sites, with 292 participants aged ≥60 years from across five states (mostly from Massachusetts), were randomized into the intervention group (IG) (16 sites; = 150 participants) and control group (CG) (13 sites; = 142 participants). The HESL workshops followed a scripted curriculum including information from the USDA's MyPlate™ and the USDA 2015-2020 dietary guidelines. Intervention elements included goal setting, self-assessment, group support, and problem solving through brainstorming. The CG received no intervention. Outcome measures were collected in both groups at baseline, 2 weeks postintervention (week 8), and 6 months postintervention. These included self-reported lifestyle behaviors, a composite healthy behavior index (HBI), body mass index [weight (kg)/height (m)], and waist-to-hip circumference ratio (WHR). Mixed-effects regression models were used to examine the impact of the intervention. The IG showed significantly improved responses to most healthy lifestyle behavior questions at week 8 compared to the CG. However, not all improved responses were sustained at month 6. Significant improvements detected at month 6 included responses to the question on making food choices that are healthy for the heart, using MyPlate™ tools for food choices, reading nutrition labels when shopping/planning meals, and confidence in managing own health ( < 0.001 in most cases). HBI was significantly improved at week 8 and month 6 ( < 0.001). WHR decreased significantly ( < 0.05) at month 6. Positive changes in lifestyle behaviors and WHR were observed in older adults due to the HESL intervention. clinicaltrial.gov, Identifier: NCT04991844; https://clinicaltrials.gov/ct2/show/NCT04991844.
老年人面临许多慢性健康问题,包括心脏病和骨质疏松症,而这些问题可通过改变生活方式行为来预防。“老年人成功生活的健康饮食™”(HESL)是一项为期6周的社区教育项目,专为60岁及以上人群设计,旨在促进向健康生活方式的行为转变。我们的目标是评估HESL。这是自2005年启动以来对HESL的首次正式评估。一项整群随机对照试验。项目实施和评估于2018年7月至2020年1月进行。来自五个州(主要来自马萨诸塞州)的29个地点的292名60岁及以上参与者被随机分为干预组(IG)(16个地点;150名参与者)和对照组(CG)(13个地点;142名参与者)。HESL工作坊遵循一份脚本化课程,包括来自美国农业部“我的餐盘™”和美国农业部2015 - 2020年饮食指南的信息。干预要素包括目标设定、自我评估、小组支持以及通过头脑风暴解决问题。CG未接受任何干预。在基线、干预后2周(第8周)和干预后6个月收集两组的结果指标。这些指标包括自我报告的生活方式行为、综合健康行为指数(HBI)、体重指数[体重(千克)/身高(米)]以及腰臀围比(WHR)。使用混合效应回归模型来检验干预的影响。与CG相比,IG在第8周时对大多数健康生活方式行为问题的回答有显著改善。然而,并非所有改善的回答在第6个月时都得以维持。在第6个月检测到的显著改善包括对关于做出对心脏健康的食物选择、使用“我的餐盘™”工具进行食物选择、购物/计划膳食时阅读营养标签以及管理自身健康的信心等问题的回答(大多数情况下P < 0.001)。HBI在第8周和第6个月时有显著改善(P < 0.001)。WHR在第6个月时显著下降(P < 0.05)。由于HESL干预,在老年人中观察到生活方式行为和WHR出现了积极变化。ClinicalTrials.gov标识符:NCT04991844;https://clinicaltrials.gov/ct2/show/NCT04991844 。
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