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Effectiveness of an intervention designed based on the Health Action Process Approach on obesity surgery outcomes in patients who have undergone bariatric surgery after one year: A randomized controlled trial.

作者信息

Maghsoodlo Maryam, Shakibazadeh Elham, Yaseri Mehdi, Mokhtari Zeinab, Barzin Maryam, Salimi Yahya

机构信息

Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.

Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

PLoS One. 2025 Apr 9;20(4):e0314316. doi: 10.1371/journal.pone.0314316. eCollection 2025.


DOI:10.1371/journal.pone.0314316
PMID:40203003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11981231/
Abstract

BACKGROUND: Bariatric surgery is effective in treating severe obesity. However, surgery alone, without additional behavior change management, may not lead to optimal long-term weight loss and maintenance. This study aimed to evaluate an intervention designed based on the Health Action Process Approach to improve outcomes of obesity surgery in patients who underwent bariatric surgery in Tehran, Iran. METHODS: In this randomized controlled trial, a total of 100 patients who had undergone bariatric surgery after the past year were randomly assigned to two intervention (n = 50) and control (n = 50) groups. The intervention group received educational intervention for two months. Health action process approach (HAPA) constructs, the Bariatric Surgery Self-Management Behaviors Questionnaire (BSSQ), dietary recall, blood chemistry parameters, BMI, percentage of body weight loss, and the International Physical Activity Questionnaire (IPAC) were measured at baseline and four months after the intervention. To compare the changes between the two groups before and four months after the educational intervention, the interaction of group and time was analyzed using the generalized estimating equation (GEE). A p-value of less than 0.05 was considered statistically significant. RESULTS: The educational intervention resulted in improvements in various aspects of self-efficacy, including task and coping self-efficacy constructs (P = 0.02), action planning (P < 0.01) and behavioral intention (P < 0.01) related to diet self-management. There were also statistically significant improvements in action planning (P = 0.02), risk perception (P = 0.01) and Recovery self- efficacy (P = 0.01) related to the self-management of physical activity. There were significant improvements in the iron blood test results (P =  0.01) among the patients. CONCLUSION: Our intervention, designed based on the Health Action Process Approach, led to improvements in dietary and physical activity outcomes among patients who underwent bariatric surgery. Trial Registration: Iran Randomized Clinical Trials IRCT20230722058887N1.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c860/11981231/5b47a2f5c6c4/pone.0314316.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c860/11981231/5b47a2f5c6c4/pone.0314316.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c860/11981231/5b47a2f5c6c4/pone.0314316.g001.jpg

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本文引用的文献

[1]
Nutritional deficiency in South African adults scheduled for bariatric surgery.

Front Endocrinol (Lausanne). 2023

[2]
Effect of diet-induced weight loss on iron status and its markers among young women with overweight/obesity and iron deficiency anemia: a randomized controlled trial.

Front Nutr. 2023-5-22

[3]
The Impact of Age, Gender, Temporality, and Geographical Region on the Prevalence of Obesity and Overweight in Saudi Arabia: Scope of Evidence.

Healthcare (Basel). 2023-4-15

[4]
Estimates and Forecasts on the Burden of Prediabetes and Diabetes in Adult and Elderly Population in Turkiye.

Eur J Epidemiol. 2023-3

[5]
Self-management After Bariatric Surgery: a Comparison Between Support Group Participants and Patients Receiving Individual Dietary Follow-Up.

Obes Surg. 2023-3

[6]
Association of Amount of Weight Lost After Bariatric Surgery With Intracranial Pressure in Women With Idiopathic Intracranial Hypertension.

Neurology. 2022-9-13

[7]
Current state of the definition and terminology related to weight recurrence after metabolic surgery: review by the POWER Task Force of the American Society for Metabolic and Bariatric Surgery.

Surg Obes Relat Dis. 2022-7

[8]
Participating in Bariatric Support Groups: the Effects on Self-management Changes.

Int J Behav Med. 2023-2

[9]
Nutritional Deficiencies Before and After Bariatric Surgery: Prevention and Treatment.

Curr Nutr Rep. 2022-6

[10]
The effectiveness of an intervention designed based on health action process approach on diet and medication adherence among patients with type 2 diabetes: a randomized controlled trial.

Diabetol Metab Syndr. 2022-1-4

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