A randomized trial comparing weight loss treatment delivered in large versus small groups.
A randomized trial comparing weight loss treatment delivered in large versus small groups.
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DOI：
10.1186/s12966-014-0123-y
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发表时间：
2014-09-24
期刊：
影响因子：
--
通讯作者：
Perri MG
中科院分区：
文献类型：
--
作者：
Dutton GR;Nackers LM;Dubyak PJ;Rushing NC;Huynh TV;Tan F;Anton SD;Perri MG
针对肥胖症的行为干预通常是在群体中进行的，尽管群体大小对减肥的影响尚未进行经验评估。这项行为减肥试验比较了6个月和12个月的体重变化，这些变化与大组（LG）或小组（SG）中提供的干预措施有关。从健康维护组织招募的肥胖成人（N = 66;平均年龄= 50岁;平均BMI = 36.5 kg/m2; 47%非裔美国人; 86%女性）被随机分配至：1）LG治疗（30名成员/组）或2）SG治疗（12名成员/组）。治疗的频率和持续时间相当，包括24周一次的小组会议（1 - 6个月），然后是6个月一次的延长护理接触（7 - 12个月）。采用具有非结构化协方差矩阵的混合效应模型分析体重变化的主要结局，同时考虑基线体重和参与者测量值随时间的依赖性。SG参与者在第6个月（-6.5 vs.-3.2 kg; p = 0.03）和第12个月（-7.0 vs.-1.7 kg; p <0.002）的体重减轻明显多于LG参与者。SG参与者在第6个月和第12个月报告了更好的治疗参与和自我监测依从性，ps <0.04，依从性完全介导了组大小和体重减轻之间的关系。在较小的群体中接受肥胖治疗可能会促进更大的体重减轻和体重减轻的维持。这种效应可能是由于SG相互作用促进的粘附性改善。这些新的研究结果表明，提供行为减肥治疗的LG的感知效率应该与SG方法实现的潜在更好的结果相平衡。
Behavioral interventions for obesity are commonly delivered in groups, although the effect of group size on weight loss has not been empirically evaluated. This behavioral weight loss trial compared the 6- and 12-month weight changes associated with interventions delivered in a large group (LG) or small groups (SG). Obese adults (N = 66; mean age = 50 years; mean BMI = 36.5 kg/m2; 47% African American; 86% women) recruited from a health maintenance organization were randomly assigned to: 1) LG treatment (30 members/group), or 2) SG treatment (12 members/group). Conditions were comparable in frequency and duration of treatment, which included 24 weekly group sessions (months 1–6) followed by six monthly extended care contacts (months 7–12). A mixed effects model with unstructured covariance matrix was applied to analyze the primary outcome of weight change while accounting for baseline weight and dependence among participants’ measurements over time. SG participants lost significantly more weight than LG participants at Month 6 (−6.5 vs. -3.2 kg; p = 0.03) and Month 12 (−7.0 vs. -1.7 kg; p < 0.002). SG participants reported better treatment engagement and self-monitoring adherence at Months 6 and 12, ps < 0.04, with adherence fully mediating the relationship between group size and weight loss. Receiving obesity treatment in smaller groups may promote greater weight loss and weight loss maintenance. This effect may be due to improved adherence facilitated by SG interactions. These novel findings suggest that the perceived efficiency of delivering behavioral weight loss treatment to LGs should be balanced against the potentially better outcomes achieved by a SG approach.
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影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
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3.7
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影响因子：
--
作者：
Perri, Michael G.;Limacher, Marian C.;Durning, Patricia E.;Janicke, David M.;Lutes, Lesley D.;Bobroff, Linda B.;Dale, Martha Sue;Daniels, Michael J.;Radcliff, Tiffany A.;Martin, A. Daniel
通讯作者：
Martin, A. Daniel