Yu Bin, Li Yuchen, Ma Chunlan, Reinhardt Jan D, Dou Qingyu, Zuo Haojiang, Yang Xue, Li Ming, Cai Changwei, Fan Yunzhe, Huang Zixing, Pang Tong, Tang Qi, Yang Fen, Ye Tingting, Jia Peng, Yang Shujuan
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Institute for Disaster Management and Reconstruction, Sichuan University-The Hongkong Polytechnic University, Chengdu, Sichuan, China.
BMC Med. 2025 May 28;23(1):302. doi: 10.1186/s12916-025-04135-6.
Mobile health (mHealth) lifestyle interventions have showed promise in improving healthy lifestyles and reducing metabolic syndrome (MetS) risk, yet most studies adopt isolated frameworks. The 3SLIFE model-integrating the socioecological model, smart devices, and self-management strategies-provides a holistic approach to sustained behavioral change. It considers environmental influences, empowers individuals in goal-setting and engagement, and leverages smart devices for monitoring and feedback. Despite its potential, evidence on this integrated approach remains scarce. This study applies 3SLIFE to community-dwelling adults, aiming to improve healthy lifestyles.
In this parallel, cluster-randomized controlled trial, 20 communities in Southwestern China were randomly assigned 1:1 to either the intervention or control group. Participants in the intervention group received the 3SLIFE intervention for 6 months, while those in the control group received routine management. The healthy lifestyle score was calculated for each participant based on smoking, alcohol intake, physical activity, dietary habits, and overweight/obesity. The primary outcome was the change in the healthy lifestyle score at the end of the 6-month trial. Differences in the score between groups were estimated using generalized linear mixed-effects models in the intention-to-treat population at 3, 6, and 12 months of follow-up.
From April to July 2023, 383 community-dwelling adults (mean age: 57.64 ± 11.32 years; 42.30% male) were recruited-190 in the intervention group and 193 in the control group. After the 6-month intervention, the increase in the healthy lifestyle score was slightly higher in the intervention group (13.22 ± 3.30 to 13.40 ± 2.88) than in the control group (13.34 ± 3.10 to 12.79 ± 3.32), with a mean difference of 0.77 (95% CI, 0.17 to 1.38). A higher proportion in the intervention group reduced at least one unhealthy lifestyle compared to the control group (31.48% vs. 19.64%, P = 0.016). However, no significant difference in score change was observed between groups at 12-month follow-up.
This study provides evidence that the 3SLIFE intervention could modestly improve healthy lifestyles in a community-based population, but the effects were not sustained at the 12-month follow-up. A further refinement is needed to enhance the intervention's long-term effectiveness in promoting sustainable lifestyle changes and reduce MetS risk in communities.
Chinese Clinical Trial Registry Identifier: ChiCTR2300070575.
移动健康（mHealth）生活方式干预在改善健康生活方式和降低代谢综合征（MetS）风险方面已显示出前景，但大多数研究采用的是孤立的框架。3SLIFE模型——整合了社会生态模型、智能设备和自我管理策略——提供了一种实现持续行为改变的整体方法。它考虑环境影响，赋予个体设定目标和参与的能力，并利用智能设备进行监测和反馈。尽管其具有潜力，但关于这种综合方法的证据仍然很少。本研究将3SLIFE应用于社区居住的成年人，旨在改善健康生活方式。
在这项平行、整群随机对照试验中，中国西南部的20个社区被1:1随机分配到干预组或对照组。干预组的参与者接受了6个月的3SLIFE干预，而对照组的参与者接受常规管理。根据吸烟、饮酒、身体活动、饮食习惯和超重/肥胖情况为每个参与者计算健康生活方式得分。主要结局是6个月试验结束时健康生活方式得分的变化。在随访的3个月、6个月和12个月时，使用广义线性混合效应模型在意向性分析人群中估计组间得分差异。
2023年4月至7月，招募了383名社区居住的成年人（平均年龄：57.64±11.32岁；男性占42.30%）——干预组有190人，对照组有193人。经过6个月的干预，干预组的健康生活方式得分增幅（从13.22±3.30增至13.40±2.88）略高于对照组（从13.34±3.10降至12.79±3.32），平均差异为0.77（95%CI，0.17至1.38）。与对照组相比，干预组中减少至少一种不健康生活方式的比例更高（31.48%对19.64%，P = 0.016）。然而，在1年随访时，组间得分变化未观察到显著差异。
本研究提供的证据表明，3SLIFE干预可适度改善社区人群的健康生活方式，但在12个月随访时效果未持续。需要进一步完善以提高干预在促进可持续生活方式改变和降低社区MetS风险方面的长期有效性。
中国临床试验注册中心标识符：ChiCTR2300070575。
