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基于家庭的成人体重管理干预措施:印度一项整群随机对照试验的结果

Family-Based Interventions to Promote Weight Management in Adults: Results From a Cluster Randomized Controlled Trial in India.

作者信息

Panniyammakal Jeemon, Stanley Antony, Ismail Sunaib, Lekha Thoniparambil R, Ganapathi Sanjay, Harikrishnan Sivadasanpillai

机构信息

Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India

Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

出版信息

Ann Fam Med. 2025 Mar 24;23(2):93-99. doi: 10.1370/afm.230632.

Abstract

BACKGROUND

We evaluated the effectiveness of a structured family-based cardiovascular health promotion intervention model in improving weight management among adults.

METHODS

We conducted an open label, cluster randomized controlled trial () with families serving as the unit of intervention. Families were randomly assigned via computer-generated numbers to receive either the comprehensive package of interventions or enhanced usual care in a 1:1 ratio. Nonphysician health workers delivered the comprehensive package of interventions, which included annual screening for cardiovascular risk factors, structured lifestyle modification sessions, referral to a primary health care facility for individuals with established risk factors, and active follow-up to evaluate self-care adherence. Weight, body mass index (BMI), and waist circumference were measured at baseline, 1 year, and 2 years to assess the intervention's effect on weight management. We used a generalized estimating equation model to analyze the between-group population average changes in these anthropometric parameters.

RESULTS

In total, 1,671 participants (1,111 women) from 750 families participated. The mean age of the study population was 40.8 (SD = 14.2) years. The attrition rate at the 2-year follow-up was 3%. The adjusted population average change attributable to the intervention at the 2-year follow-up were -2.61 kg in weight (95% CI, -3.95 to -1.26; <.001), -1.06 kg/m in BMI (95% CI, -1.55 to -0.58; <.001), and -4.17 cm in waist circumference (95% CI, -5.38 to -2.96; <.001).

CONCLUSION

The reduction in weight achieved in the family-based intervention could have a substantial public health impact in preventing future diabetes and other noncommunicable disease conditions.

摘要

背景

我们评估了一种基于家庭的结构化心血管健康促进干预模式在改善成年人体重管理方面的有效性。

方法

我们进行了一项开放标签、整群随机对照试验,以家庭作为干预单位。通过计算机生成的数字将家庭以1:1的比例随机分配,分别接受综合干预措施或强化常规护理。非医生卫生工作者提供综合干预措施,包括每年筛查心血管危险因素、结构化的生活方式改变课程、将有既定危险因素的个体转诊至初级卫生保健机构,以及积极随访以评估自我护理依从性。在基线、1年和2年时测量体重、体重指数(BMI)和腰围,以评估干预对体重管理的影响。我们使用广义估计方程模型分析这些人体测量参数在组间的总体平均变化。

结果

共有来自750个家庭的1671名参与者(1111名女性)参与。研究人群的平均年龄为40.8(标准差 = 14.2)岁。2年随访时的失访率为3%。在2年随访时,干预导致的调整后总体平均变化为体重减轻2.61千克(95%置信区间,-3.95至-1.26;P <.001),BMI降低1.06千克/平方米(95%置信区间,-1.55至-0.58;P <.001),腰围减少4.17厘米(95%置信区间,-5.38至-2.96;P <.001)。

结论

基于家庭的干预所实现的体重减轻可能对预防未来的糖尿病和其他非传染性疾病状况产生重大的公共卫生影响。

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