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一项适应性工作场所糖尿病预防试验对健康行动过程方法中饮食摄入和身体活动相关结果的影响。

Impact of an Adaptive Worksite Diabetes Prevention Trial on Health Action Process Approach Outcomes Regarding Dietary Intake and Physical Activity.

作者信息

King Danielle E, Miller Carla K, Nagaraja Haikady N, Fujita Kentaro, Cheavens Jennifer S

机构信息

SUNY Buffalo State University.

Indiana University.

出版信息

Health Behav Res. 2024 Mar;7(2). doi: 10.4148/2572-1836.1218. Epub 2024 May 31.

Abstract

Weight loss, through a reduction in energy intake and increase in energy expenditure, can reduce diabetes risk in people with prediabetes. However, lifestyle change can be challenging even with positive intentions. The Health Action Process Approach (HAPA) theoretical framework bridges the intention-behavior gap by targeting planning behaviors and strengthening efficacious beliefs for behavioral change. In the current trial, an adaptive design was employed to examine differences in HAPA measures (i.e., planning and self-efficacy) regarding the target behaviors of dietary intake and physical activity (PA). Adults ≥ 21 years old with overweight or obesity and prediabetes (n = 185) received the standard Group Lifestyle Balance (GLB) intervention during the first month of treatment. Weight loss responders (lost > 2.5% of weight) at week five remained in GLB during weeks 5-16; slow responders (lost ≤ 2.5%) were stratified to the adaptive GLB Plus (GLB+) intervention during weeks 5-16. GLB+ augmented self-regulatory skills and practices consistent with HAPA. We conducted mixed model analyses with a group-by-time interaction for fixed effects at four months. GLB experienced greater improvement in behavioral intention for both diet and PA, planning behaviors (action and coping planning) for diet, and self-efficacy beliefs (action and maintenance self-efficacy) for PA compared to GLB+ (all s < .0125). However, GLB+ also experienced statistically significant improvement in planning and self-efficacy and in energy intake and food group servings (all s < .01). Whereas an adaptive intervention can be advantageous in improving HAPA measures and food choices, greater focus on increasing PA is needed. Additional research may help to determine effective PA strategies.

摘要

通过减少能量摄入和增加能量消耗来减轻体重,可以降低糖尿病前期人群患糖尿病的风险。然而,即使有积极的意愿,改变生活方式也可能具有挑战性。健康行动过程方法(HAPA)理论框架通过针对计划行为和强化行为改变的有效信念,弥合了意图与行为之间的差距。在当前的试验中,采用了一种适应性设计,以检验HAPA措施(即计划和自我效能)在饮食摄入和身体活动(PA)等目标行为方面的差异。年龄≥21岁、超重或肥胖且患有糖尿病前期的成年人(n = 185)在治疗的第一个月接受了标准的团体生活方式平衡(GLB)干预。在第5周体重减轻的应答者(体重减轻>2.5%)在第5 - 16周继续接受GLB干预;缓慢应答者(体重减轻≤2.5%)在第5 - 16周被分层接受适应性GLB加(GLB +)干预。GLB +增强了与HAPA一致的自我调节技能和实践。我们进行了混合模型分析,在四个月时对固定效应采用组×时间交互作用。与GLB +相比,GLB在饮食和PA的行为意图、饮食的计划行为(行动和应对计划)以及PA的自我效能信念(行动和维持自我效能)方面有更大的改善(所有p <.0125)。然而,GLB +在计划和自我效能以及能量摄入和食物组摄入量方面也有统计学上的显著改善(所有p <.01)。虽然适应性干预在改善HAPA措施和食物选择方面可能具有优势,但需要更加关注增加PA。进一步的研究可能有助于确定有效的PA策略。

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