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适应性电话辅导干预在线减肥计划中的患者:一项随机临床试验
Jessica L Unick1,2, Christine A Pellegrini3, Shira I Dunsiger4
1Warren Alpert Medical School at Brown University, Providence, Rhode Island.
JAMA network open
|June 7, 2024
概括
将电话辅导添加到在线减肥计划中,显著改善了低于最佳初始反应的个体的减肥结果. 简短和扩展的辅导都比没有辅导更有效,证明了成本效益.
科学领域:
- 肥胖研究的研究.
- 行为医学是一种行为医学.
- 数字健康干预措施 数字健康干预措施
背景情况:
- 在行为计划中早期减肥 (WL) 预测了长期的成功.
- 适应性干预措施是需要的肥胖管理.
- 低于最佳的初始WL需要有针对性的支持.
研究的目的:
- 为了比较简短,扩展和没有电话辅导的有效性,在线辅导计划中对具有低于最佳响应 (<4% WL在1个月内) 的个人进行辅导.
- 评估教练对4个月和12个月的WL的影响.
- 评估辅导干预措施的成本效益.
主要方法:
- 随机临床试验与437名参与者 (BMI 25-45,年龄18-70).
- 参与者接受了为期4个月的在线WL计划;那些反应不佳的人被随机分为简要 (3个电话),延长 (12个电话) 或没有电话辅导.
- 主要结局:百分比WL和比例达到≥5%的WL在4个月和12个月.
主要成果:
- 与对照组相比,简短和延长的辅导在4个月内显著增加了WL (P<.001).
- 在短期 (58.5%) 和扩展 (65.9%) 的指导与控制 (36.5%) 之间,在4个月内达到≥5%的WL的比例更高.
- 扩展辅导与控制 (P=.03) 在12个月内仍然存在显著的WL差异;两个辅导组都增加了计划参与度.
结论:
- 电话辅导是对在线WL课程的有效,成本效益高的补充,用于低于最佳初始响应的个人.
- 结合辅导的适应性干预可以改善肥胖治疗结果.
- 建议在医疗保健系统等临床环境中进行进一步的测试.
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