School of Medicine and Public Health, University of Newcastle, NSW, Australia.
Division of Medicine, Hunter New England Local Health District, NSW, Australia.
BMC Public Health. 2024 Sep 2;24(1):2372. doi: 10.1186/s12889-024-19849-0.
The effectiveness of the NSW Health "Get Healthy Information and Coaching Service(Get Healthy) to facilitate weight loss on a population scale has been documented, but this was based on self-reported measures. Our study aims to test the effectiveness of the Get Healthy Service on objectively measured weight, BMI, waist circumference, and changes in other health behaviours, including nutrition, physical activity and alcohol intake.
Men and women aged 40-70 years (n = 154) with pre-diabetes (5.7% < HbA1c < 6.5%) were referred from GP Practices to the Get Healthy Service, NSW Health. A subset (n = 98) participated in the "Zinc In Preventing the Progression of pre-Diabetes" (ZIPPeD) trial (ACTRN12618001120268).
The self-reported outcomes showed a statistically significant improvement from baseline to 12 months in weight (mean 2.7 kg loss, p < 0.001), BMI (mean 1 unit reduction, p < 0.001), and waist circumference (mean 4.3 cm reduction, p < 0.001). However, in the objectively measured outcomes from ZIPPeD, the differences were more modest, with point estimates of 0.8 kg mean weight loss (p = 0.1), 0.4 unit reduction in BMI (p = 0.03), and 1.8 cm reduction in waist circumference (p = 0.04). Bland-Altman plots indicated that discrepancies were due to a small number of participants who dramatically underestimated their weight or BMI. There were minimal changes in nutrition, physical activity, and alcohol.
The potential benefits of Get Healthy should be interpreted with caution as we have shown significant differences between self-reported and objectively measured values. More valid and objective evidence is needed to determine the program's effectiveness and cost-effectiveness.
新南威尔士州卫生厅的“健康信息和指导服务（Get Healthy）在促进大规模人群减肥方面的效果已经得到了证明，但这是基于自我报告的测量结果。我们的研究旨在测试 Get Healthy 服务对体重、BMI、腰围等客观测量结果的有效性，以及对其他健康行为（包括营养、身体活动和饮酒）的变化。
患有前期糖尿病（5.7%<HbA1c<6.5%）的 40-70 岁男性和女性（n=154）从全科医生诊所被转诊到 Get Healthy 服务处，新南威尔士州卫生厅。其中一个亚组（n=98）参加了“锌在预防前期糖尿病进展中的作用（ZIPPeD）”试验（ACTRN12618001120268）。
自我报告的结果显示，从基线到 12 个月时，体重（平均减轻 2.7 公斤，p<0.001）、BMI（平均减少 1 个单位，p<0.001）和腰围（平均减少 4.3 厘米，p<0.001）有统计学意义的改善。然而，在 ZIPPeD 的客观测量结果中，差异更为温和，体重平均下降 0.8 公斤（p=0.1），BMI 减少 0.4 个单位（p=0.03），腰围减少 1.8 厘米（p=0.04）。Bland-Altman 图表明，差异是由于一小部分参与者严重低估了自己的体重或 BMI。营养、身体活动和饮酒方面的变化很小。
由于我们已经显示出自报和客观测量值之间存在显著差异，因此对 Get Healthy 的潜在益处的解释应谨慎。需要更有效和客观的证据来确定该计划的效果和成本效益。
