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在妇科肿瘤诊疗实践中对超重和肥胖女性进行生活方式改变干预的整合。

Integration of a lifestyle modification intervention for women with overweight and obesity in a gynecologic oncology practice.

作者信息

Morris David H, Kosmacki Alison, Tolby Leah, Marx Christine, Vanderlan Jessica, Mutch David G, Colditz Graham, Hagemann Andrea R

机构信息

Department of Psychiatry, Alvin J. Siteman Cancer Center, St. Louis, MO, USA.

Department of Obstetrics & Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.

出版信息

Gynecol Oncol. 2025 May;196:168-174. doi: 10.1016/j.ygyno.2025.04.516. Epub 2025 Apr 12.

Abstract

OBJECTIVE(S): We aimed to assess the feasibility and effectiveness of a remotely delivered, group-based lifestyle modification intervention (LMI) for women with gynecologic cancer and overweight or obesity in a real-world clinic.

METHODS

A six-month LMI was implemented in an outpatient gynecologic oncologic clinic for women with a body mass index (BMI) >25 kg/m. Participants were given a weight loss goal of ≥5 % initial body weight. Retrospective data were collected from patients enrolled in the intervention from September 2019 through February 2023. Feasibility of the LMI was assessed by the rate of enrollment and retention in the intervention. De-identified zip code data were collected to assess geographic proximity of participants to the clinic. Repeated measure analysis of variance (ANOVA) was performed to evaluate change in weight across the intervention.

RESULTS

164 patients were referred to the LMI with 82 patients being enrolled during the study timeframe. The sample consisted primarily of white (68.3 %) women between the ages of 30 to 73 years old (median age of 57) with an initial median BMI of 41.41 kg/m. 74 % of enrolled patients completed the entire LMI. The LMI resulted in a mean loss of 4.19 kgs (p < .001), with 40.30 % of patients losing ≥5 % initial body weight.

CONCLUSIONS

Remotely delivered, group based LMI for gynecologic cancer patients with overweight or obesity is feasible in clinical practice and can transcend rural-urban inequalities. Patients in the LMI achieved statistically and clinically significant weight loss, comparable to that observed in more rigorous clinical trial.

摘要

目的

我们旨在评估在现实世界的诊所中,为患有妇科癌症且超重或肥胖的女性提供的远程、基于群体的生活方式改变干预措施(LMI)的可行性和有效性。

方法

在一家门诊妇科肿瘤诊所,对体重指数(BMI)>25 kg/m²的女性实施了为期六个月的LMI。参与者被设定了初始体重减轻≥5%的目标。收集了2019年9月至2023年2月参加干预的患者的回顾性数据。通过干预的入组率和留存率评估LMI的可行性。收集了经过去识别处理的邮政编码数据,以评估参与者与诊所的地理距离。进行重复测量方差分析(ANOVA)以评估整个干预过程中的体重变化。

结果

164名患者被转介至LMI,其中82名患者在研究期间入组。样本主要由年龄在30至73岁之间(中位年龄57岁)的白人女性(68.3%)组成,初始中位BMI为41.41 kg/m²。74%的入组患者完成了整个LMI。LMI导致平均体重减轻4.19千克(p <.001),40.30%的患者体重减轻≥初始体重的5%。

结论

对于超重或肥胖的妇科癌症患者,远程、基于群体的LMI在临床实践中是可行的,并且可以跨越城乡不平等。LMI中的患者在统计学和临床上都实现了显著的体重减轻,与在更严格的临床试验中观察到的情况相当。

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