School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA.
The University of Tennessee Health Science Center, 920 Madison Ave., Memphis, TN, 38163, USA.
BMC Prim Care. 2023 Oct 5;24(1):205. doi: 10.1186/s12875-023-02162-x.
Healthy Lifetime, a theoretically driven, personalized health coaching program delivered electronically, including face-to-face videoconferencing, was developed to intervene in early aging to stave off functional decline and minimize the onset/exacerbation of chronic conditions.
To determine the efficacy of a theoretically driven, personalized health coaching program in participants 50 years and older with one or more chronic conditions using a randomized, controlled, pragmatic clinical trial methodology.
Participants were randomly assigned to the HL (n = 59) or a usual care (n = 63) group. The HL group received health coaching from a trained nurse over eight weeks. Outcomes were measured at baseline, eight weeks, and 20 weeks (after the 12-week no-treatment phase). Regression modeling with fixed-effect repeated measures was used to account for the longitudinal data collection.
For the HL group, health habits increased at 8 weeks (3.1 units; SE = 1.0; p = .0005; effect size = .15). This difference was sustained at 20 weeks (2.4 units, SE = 0.2; p = .0005). Independent self-care agency improved at 8 weeks in individuals with high blood pressure (13.5 units; SE = 4.37; p = .0023; effect size = .3). However, that difference was not sustained at 20 weeks (p = .47). No significant improvements were shown in the usual care group at 8 weeks or 20 weeks.
HL participants significantly improved their health habits at 8 weeks and sustained this improvement at week 20 (after a 12-week no-treatment phase) vs. the usual care group. Changing health habits alone has been shown to reduce all-cause morbidity and mortality in chronic disease. The high-functioning, community-dwelling older adults with chronic diseases we studied is an important target population for primary care practices to intervene early in aging to stave off the complications of chronic disease and functional decline.
ClinicalTrials.gov (record NCT05070923, 07/10/2021).
Healthy Lifetime 是一个理论驱动的个性化健康辅导计划，通过电子方式提供，包括面对面视频会议，旨在干预早期衰老，防止功能下降，并最小化慢性疾病的发生/加重。
使用随机、对照、实用的临床试验方法，确定针对 50 岁及以上、患有一种或多种慢性疾病的参与者的理论驱动的个性化健康辅导计划的疗效。
参与者被随机分配到 HL 组（n=59）或常规护理组（n=63）。HL 组接受了经过培训的护士为期八周的健康辅导。在基线、八周和 20 周（12 周无治疗阶段后）进行了测量。使用固定效应重复测量回归模型来解释纵向数据收集。
对于 HL 组，健康习惯在八周时增加（3.1 个单位；SE=1.0；p=0.0005；效应大小=0.15）。这种差异在 20 周时仍保持（2.4 个单位，SE=0.2；p=0.0005）。高血压患者的独立自我护理能力在八周时提高（13.5 个单位；SE=4.37；p=0.0023；效应大小=0.3）。然而，这一差异在 20 周时没有持续（p=0.47）。常规护理组在八周或 20 周时均未显示出显著改善。
HL 组参与者的健康习惯在八周时显著改善，并在 20 周（12 周无治疗阶段后）保持这种改善，与常规护理组相比。改变健康习惯已被证明可以降低慢性疾病的全因发病率和死亡率。我们研究的患有慢性疾病的高功能、社区居住的老年成年人是初级保健实践的重要目标人群，以便在衰老早期进行干预，防止慢性疾病和功能下降的并发症。
ClinicalTrials.gov（记录号 NCT05070923，07/10/2021）。
