在社区随机心血管疾病风险降低干预中，饮食摄入、行为和心理社会措施的改善：强壮的心，健康的社区 2.0。
Improvements in dietary intake, behaviors, and psychosocial measures in a community-randomized cardiovascular disease risk reduction intervention: Strong Hearts, Healthy Communities 2.0.
机构信息
Texas A&M Institute for Advancing Health Through Agriculture, Dallas, TX, United States.
Tufts University, Friedman School of Nutrition, Boston, MA, United States.
出版信息
Am J Clin Nutr. 2023 Nov;118(5):1055-1066. doi: 10.1016/j.ajcnut.2023.09.003. Epub 2023 Sep 17.
BACKGROUND
Cardiovascular disease (CVD) prevalence has disproportionately risen among midlife and older female adults of rural communities, partly due to poor diet and diet-related behaviors and psychosocial factors that impede healthy eating.
OBJECTIVES
This study aimed to evaluate the impact of Strong Hearts Healthy Communities 2.0 (SHHC-2.0) on secondary diet-related outcomes between intervention and control participants that align with the dietary goal and behavioral aims of the SHHC-2.0, a CVD risk reduction program.
METHODS
A community-randomized controlled trial was conducted in rural, medically underserved communities. Participants were female adults ≥40 y who were classified as obese or both overweight and sedentary. Communities were randomized to SHHC-2.0 intervention (n = 5 communities; n = 87 participants) or control (with delayed intervention) (n = 6 communities; n = 95 participants). SHHC-2.0 consisted of 24 wk of twice-weekly experiential nutrition education and group-based physical activity classes led by local health educators. Changes between baseline and end point (24 wk) in dietary intake (24-h recalls), dietary behaviors (e.g., Rapid Eating Assessment for Participants-Short Version [REAP-S] scores) and diet-related psychosocial measures (e.g., Three Factor Eating questionnaire) between groups were analyzed using linear mixed-effects multilevel models.
RESULTS
At 24 wk, participants from the 5 intervention communities, compared with controls, consumed fewer calories (mean difference [MD]= -211 kcal, 95% CI: -412, -110, P = 0.039), improved overall dietary patterns measured by REAP-S scores (MD: 3.9; 95% CI: 2.26, 5.6; P < 0.001), and improved psychosocial measures (healthy eating attitudes, uncontrolled eating, cognitive restraint, and emotional eating).
CONCLUSIONS
SHHC-2.0 has strong potential to improve diet patterns and diet-related psychosocial wellbeing consistent with improved cardiovascular health. This trial was registered at www.
CLINICALTRIALS
gov as NCT03059472.
背景
心血管疾病（CVD）在农村社区的中年和老年女性中不成比例地上升，部分原因是不良饮食和与饮食相关的行为以及阻碍健康饮食的心理社会因素。
目的
本研究旨在评估 Strong Hearts Healthy Communities 2.0（SHHC-2.0）对干预和对照组参与者与 SHHC-2.0 的饮食目标和行为目标一致的次要饮食相关结果的影响，SHHC-2.0 是一项降低 CVD 风险的计划。
方法
在农村医疗服务不足的社区进行了一项社区随机对照试验。参与者为年龄≥40 岁的女性成年人，被归类为肥胖或超重且久坐不动。社区随机分为 SHHC-2.0 干预组（n=5 个社区；n=87 名参与者）或对照组（延迟干预）（n=6 个社区；n=95 名参与者）。SHHC-2.0 包括 24 周每周两次的体验式营养教育和由当地健康教育家领导的团体体能活动课程。使用线性混合效应多层次模型分析组间基线和终点（24 周）之间饮食摄入（24 小时回顾）、饮食行为（例如，参与者快速饮食评估-简短版本[REAP-S]评分）和与饮食相关的心理社会措施（例如，三因素饮食问卷）的变化。
结果
在 24 周时，与对照组相比，来自 5 个干预社区的参与者摄入的卡路里更少（平均差异[MD]=-211kcal，95%CI：-412，-110，P=0.039），REAP-S 评分整体饮食模式有所改善（MD：3.9；95%CI：2.26，5.6；P<0.001），以及改善了心理社会措施（健康饮食态度、失控饮食、认知约束和情绪性饮食）。
结论
SHHC-2.0 具有很强的潜力，可以改善与改善心血管健康一致的饮食模式和与饮食相关的心理社会健康。该试验在 www.clinicaltrials.gov 上注册为 NCT03059472。
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