移动健康行为改变支持系统作为肥胖症的独立治疗工具：一项随机对照试验。
Mobile health behaviour change support system as independent treatment tool for obesity: a randomized controlled trial.
机构信息
Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland.
Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
出版信息
Int J Obes (Lond). 2024 Mar;48(3):376-383. doi: 10.1038/s41366-023-01426-x. Epub 2023 Dec 7.
BACKGROUND/OBJECTIVES: Digital health interventions are increasingly utilized as an adjunct to face-to-face counselling in the treatment of obesity. However, previous studies have shown inconsistent efficacy when digital interventions are used as stand-alone treatment. The purpose of this study was to investigate whether a mobile health behaviour change support system (mHBCSS) is effective in weight reduction and weight loss maintenance without additional counselling. Furthermore, changes in cardiometabolic risk factors were investigated.
METHODS
In this randomized controlled trial, a mHBCSS intervention was conducted for 200 volunteers with obesity (BMI 30-40 kg/m² and age 18-65 years). The study participants were randomly assigned into two groups: immediate access to mHBCSS intervention or wait-list control with access to mHBCSS after 6 months. Anthropometric and metabolic traits were also measured. The primary outcome was weight loss from the baseline to the 6-month visit.
RESULTS
Among 200 participants (88.5% women), mean BMI (SD) was 34.3 kg/m² (2.8) and age 46.5 years (9.5). The retention rate was 98.5% and 89.0% at the 6- and 12-month visits, respectively. At the 6-month visit, those with immediate access to mHBCSS had significantly greater weight loss (-2.5%, 95% CI -3.4 to -1.6, p < 0.001) compared with the wait-list control group (0.2%, 95% CI -0.4 to 0.9, p = 0.466; between groups p < 0.001). Weight loss was maintained until the 12-month time point in the mHBCSS group (-2.1%, 95% CI -3.3 to -0.9, p = 0.001). The usage of mHBCSS had no significant effect on metabolic traits.
CONCLUSION
The mHBCSS as a stand-alone treatment of obesity results in weight reduction and weight loss maintenance with remarkable adherence rate. Further studies are needed to establish how to best implement the scalable and resource-efficient mHBCSS into the standard care of obesity to achieve optimal weight loss results.
背景/目的：数字健康干预措施越来越多地被用作面对面咨询的辅助手段，用于治疗肥胖症。然而，之前的研究表明，当数字干预措施作为独立治疗方法时，其效果并不一致。本研究旨在探讨移动健康行为改变支持系统（mHBCSS）在没有额外咨询的情况下，是否能有效减轻体重和维持体重减轻。此外，还研究了心血管代谢风险因素的变化。
方法
在这项随机对照试验中，对 200 名肥胖志愿者（BMI 30-40kg/m²和年龄 18-65 岁）进行了 mHBCSS 干预。研究参与者被随机分为两组：立即获得 mHBCSS 干预或等待列表控制，在 6 个月后获得 mHBCSS 干预。还测量了人体测量和代谢特征。主要结局是从基线到 6 个月访视时的体重减轻。
结果
在 200 名参与者（88.5%为女性）中，平均 BMI（标准差）为 34.3kg/m²（2.8），年龄为 46.5 岁（9.5）。保留率分别在 6 个月和 12 个月访视时为 98.5%和 89.0%。在 6 个月访视时，立即获得 mHBCSS 的参与者体重减轻幅度明显大于等待列表对照组（-2.5%，95%置信区间-3.4 至-1.6，p<0.001）（0.2%，95%置信区间-0.4 至 0.9，p=0.466；组间 p<0.001）。在 mHBCSS 组中，体重减轻一直持续到 12 个月时间点（-2.1%，95%置信区间-3.3 至-0.9，p=0.001）。mHBCSS 的使用对代谢特征没有显著影响。
结论
mHBCSS 作为肥胖症的独立治疗方法，可显著减轻体重和维持体重减轻，且依从性率高。需要进一步研究如何将可扩展且资源高效的 mHBCSS 最好地纳入肥胖症的标准护理中，以实现最佳的体重减轻效果。
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