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基于微信小程序的干预措施对促进中国心血管疾病患者居家康复中多种健康行为改变的效果:随机对照试验

Effectiveness of a WeChat Mini Program-Based Intervention on Promoting Multiple Health Behavior Changes Among Chinese Patients With Cardiovascular Diseases in Home-Based Rehabilitation: Randomized Controlled Trial.

作者信息

Duan Yanping, Liang Wei, Guo Lan, Zhan Huimin, Xia Chunli, Ma Huan, Shang Borui, Wang Yanping, Yang Min, Cheng Shishi

机构信息

Department of Sports and Health Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).

School of Physical Education, Shenzhen University, SYB 326, 3688 Nanhai Road, Nanshan District, Shenzhen, 518060, China, 86 15217940540.

出版信息

J Med Internet Res. 2025 Jun 3;27:e66249. doi: 10.2196/66249.

Abstract

BACKGROUND

WeChat mini program-based interventions grounded in behavior change theories show promise in promoting and maintaining healthy lifestyles among patients with cardiovascular diseases (CVDs) after hospital discharge. However, limited randomized controlled trials have evaluated the effectiveness of such interventions among Chinese patients with CVDs in a home-based rehabilitation context.

OBJECTIVE

This study aimed to assess the effectiveness of a 10-week WeChat mini program-based intervention on multiple health behaviors, including moderate to vigorous physical activity (MVPA), fruit and vegetable consumption (FVC), integrated lifestyle indicator (ie, meeting both MVPA and FVC recommendations), psychosocial resources (intrinsic and extrinsic) of behavior change, and health-related outcomes (ie, depressive symptoms and perceived quality of life) among Chinese patients with CVDs.

METHODS

This study recruited 166 outpatients from a cardiac rehabilitation center in China. After screening for eligibility and randomization, 124 participants (mean age 41.60, SD 13.48 years; 61.3% female) were allocated to either (1) the intervention group, which received a 10-week health program based on the Health Action Process Approach, or (2) a waitlist control group, which received no intervention and maintained their usual lifestyle. Both groups completed assessments at baseline, postintervention (10 weeks), and 3 months postintervention. Data were analyzed using generalized linear mixed models in IBM SPSS 28.0.

RESULTS

Significant time-by-group interaction effects were observed for MVPA (F2, 122=6.68; P=.002), FVC (F2, 122=18.68; P<.001), integrated lifestyle indicator (F2, 122=13.83; P<.001), intrinsic (F2, 122=11.49; P<.001) and extrinsic psychosocial resources (F2,1 22=5.35; P=.006) for MVPA, intrinsic resources for FVC (F2, 122=12.66; P<.001), and perceived quality of life (F2, 122=6.99; P=.001). The intervention group showed significant improvements in these outcomes compared to the control group, with medium-to-large effect sizes for behavior-related outcomes (d=0.57-0.88), and small-to-medium effect sizes for psychosocial and health-related outcomes (d=0.28-0.52). However, no significant effects were found for extrinsic resource for FVC (F2, 122=1.37; P=.26) or depressive symptoms (F2, 122=0.44; P=.64). Sensitivity analyses confirmed the robustness of the primary findings.

CONCLUSIONS

The 10-week Healthy Action Process Approach-based WeChat mini program intervention effectively improved MVPA, FVC, integrated lifestyle indicator, psychosocial resources of behavior change, and health-related outcomes among Chinese patients with CVDs. This intervention provides a valuable addition to rehabilitation strategies aimed at promoting long-term health and activity in cardiac patients following hospital discharge.

摘要

背景

基于行为改变理论的微信小程序干预措施在促进和维持心血管疾病(CVD)患者出院后的健康生活方式方面显示出前景。然而,在家庭康复环境中,评估此类干预措施对中国CVD患者有效性的随机对照试验有限。

目的

本研究旨在评估一项基于微信小程序的为期十周的干预措施对中国CVD患者多种健康行为的有效性,这些健康行为包括中度至剧烈身体活动(MVPA)、水果和蔬菜摄入量(FVC)、综合生活方式指标(即同时符合MVPA和FVC建议)、行为改变的心理社会资源(内在和外在)以及健康相关结局(即抑郁症状和生活质量感知)。

方法

本研究从中国一家心脏康复中心招募了166名门诊患者。在进行资格筛选和随机分组后,124名参与者(平均年龄41.60岁,标准差13.48岁;61.3%为女性)被分配到以下两组之一:(1)干预组,接受基于健康行动过程方法的为期十周的健康计划;(2)等待名单对照组,不接受干预并维持其通常的生活方式。两组均在基线、干预后(10周)和干预后3个月完成评估。使用IBM SPSS 28.0中的广义线性混合模型对数据进行分析。

结果

在MVPA(F2, 122 = 6.68;P = 0.002)、FVC(F2, 122 = 18.68;P < 0.001)、综合生活方式指标(F2, 122 = 13.83;P < 0.001)、MVPA的内在(F2, 122 = 11.49;P < 0.001)和外在心理社会资源(F2,1 22 = 5.35;P = 0.006)、FVC的内在资源(F2, 122 = 12.66;P < 0.001)以及生活质量感知(F2, 122 = 6.99;P = 0.001)方面观察到显著的组间时间交互效应。与对照组相比,干预组在这些结局方面有显著改善,行为相关结局的效应大小为中到大型(d = 0.57 - 0.88),心理社会和健康相关结局的效应大小为小到中型(d = 0.28 - 0.52)。然而,未发现FVC的外在资源(F2, 122 = 1.37;P = 0.26)或抑郁症状(F2, 122 = 0.44;P = 0.64)有显著影响。敏感性分析证实了主要研究结果的稳健性。

结论

基于健康行动过程方法的为期十周的微信小程序干预措施有效改善了中国CVD患者的MVPA、FVC、综合生活方式指标、行为改变的心理社会资源以及健康相关结局。该干预措施为旨在促进心脏病患者出院后长期健康和活动的康复策略提供了有价值的补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7110/12151454/c6af39c5d939/jmir-v27-e66249-g001.jpg

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