Institute of Nursing Science, University of Education Schwäbisch Gmünd, Oberbettringerstraße 200, 73525, Schwäbisch Gmünd, Germany.
Department of Nutrition, Exercise and Sports, University of Copenhagen, 1958, Frederiksberg, Denmark.
BMC Public Health. 2023 Aug 30;23(1):1666. doi: 10.1186/s12889-023-16569-9.
Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined.
Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes (n = 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested.
Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent (p ≤ .001) from BMI, but moderated by sex and SES.
Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs.
ClinicalTrials.gov Identifier: NCT01777893.
久坐的生活方式和不健康的饮食加上超重是 2 型糖尿病(T2D)的危险因素。减肥的生活方式干预对 T2D 预防有效,但不成功的完成和慢性压力可能会阻碍疗效。本研究旨在探讨 PREVIEW 研究开始时慢性压力和过早终止的决定因素。
对年龄在 25 至 70 岁之间患有前驱糖尿病(n=2220)的参与者,在基线时检查生活质量(QoL)、社会支持、初级保健利用和情绪,作为干预终止和慢性应激的预测因素。测试了性别和社会经济地位(SES)的调节作用以及 BMI 的预测变量的独立性。
有孩子的参与者、女性和较高 SES 的参与者比没有孩子的参与者、较低 SES 和男性更早地退出干预。较低的 QoL、缺乏家庭支持和初级保健利用与退出有关。较低的 QoL 和较高的情绪障碍与慢性压力有关。预测变量与 BMI 独立(p≤.001),但受性别和 SES 调节。
基于政策的公共卫生策略应考虑预防干预措施如何更好地适应不同的个体状态和生活情况,这可能会影响干预措施的完成。干预设计应能在交付中内置灵活性,以满足个人需求。
ClinicalTrials.gov 标识符:NCT01777893。