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一项针对澳大利亚成年人成瘾性进食行为改善的远程医疗干预的三臂随机对照试验(TRACE 项目)。

A three-arm randomised controlled trial of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program).

机构信息

School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, 2305, Australia.

School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, 3800, Australia.

出版信息

Appetite. 2024 Apr 1;195:107211. doi: 10.1016/j.appet.2024.107211. Epub 2024 Jan 11.

DOI:10.1016/j.appet.2024.107211
PMID:38215944
Abstract

There is a substantial research base for addictive eating with development of interventions. The current 3-arm RCT aimed to investigate the efficacy of the TRACE (Targeted Research for Addictive and Compulsive Eating) program to decrease addictive eating symptoms and improve mental health. Participants (18-85 yrs) endorsing ≥3 addictive eating symptoms were randomly allocated to 1) active intervention, 2) passive intervention, or 3) control group. Primary outcome was change in addictive eating symptoms 3-months post-baseline measured by the Yale Food Addiction Scale. Depression, anxiety and stress were also assessed. A total of 175 individuals were randomised. Using Linear Mixed Models, from baseline to 3-months, there was significant improvement in symptom scores in all groups with mean decrease of 4.7 (95% CI: -5.8, -3.6; p < 0.001), 3.8 (95% CI: -5.2, -2.4; p < 0.001) and 1.5 (95% CI: -2.6, -0.4; p = 0.01) respectively. Compared with the control group, participants in the active intervention were five times more likely to achieve a clinically significant change in symptom scores. There was a significant reduction in depression scores in the active and passive intervention groups, but not control group [-2.9 (95% CI: -4.5, -1.3); -2.3 (95% CI: -4.3, -0.3); 0.5 (95% CI: -1.1, 2.1), respectively]; a significant reduction in stress scores within the active group, but not passive intervention or control groups [-1.3 (95% CI: -2.2, -0.5); -1.0 (95% CI: -2.1, 0.1); 0.4 (95% CI: -0.5, 1.2), respectively]; and the reduction in anxiety scores over time was similar for all groups. A dietitian-led telehealth intervention for addictive eating in adults was more effective than a passive or control condition in reducing addictive eating scores from baseline to 6 months. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

摘要

有大量研究基础表明,成瘾性饮食与干预措施的发展密切相关。目前的这项三臂 RCT 旨在研究 TRACE(针对成瘾性和强迫性饮食的靶向研究)计划的疗效,以减少成瘾性饮食症状并改善心理健康。参与者(18-85 岁)至少有 3 项成瘾性饮食症状被随机分配到以下 3 组:1)主动干预组,2)被动干预组,或 3)对照组。主要结局是使用耶鲁食物成瘾量表(Yale Food Addiction Scale)在基线后 3 个月时测量的成瘾性饮食症状变化。还评估了抑郁、焦虑和压力。共有 175 人被随机分配。使用线性混合模型,从基线到 3 个月,所有组的症状评分均有显著改善,平均下降 4.7(95%CI:-5.8,-3.6;p<0.001)、3.8(95%CI:-5.2,-2.4;p<0.001)和 1.5(95%CI:-2.6,-0.4;p=0.01)。与对照组相比,主动干预组患者出现症状评分临床显著变化的可能性高出五倍。主动和被动干预组的抑郁评分显著降低,但对照组没有 [-2.9(95%CI:-4.5,-1.3);-2.3(95%CI:-4.3,-0.3);0.5(95%CI:-1.1,2.1)];主动组的压力评分显著降低,但被动干预组或对照组没有 [-1.3(95%CI:-2.2,-0.5);-1.0(95%CI:-2.1,0.1);0.4(95%CI:-0.5,1.2)];随着时间的推移,焦虑评分的下降在所有组中相似。与被动或对照组相比,营养师主导的远程医疗成瘾性饮食干预在减少从基线到 6 个月的成瘾性饮食评分方面更有效。试验注册:澳大利亚和新西兰临床试验注册 ACTRN12621001079831。

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