Evaluation of a Web-Based Intervention for Multiple Health Behavior Changes in Patients With Coronary Heart Disease in Home-Based Rehabilitation: Pilot Randomized Controlled Trial.
Evaluation of a Web-Based Intervention for Multiple Health Behavior Changes in Patients With Coronary Heart Disease in Home-Based Rehabilitation: Pilot Randomized Controlled Trial.
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DOI：
10.2196/12052
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发表时间：
2018-11-19
影响因子：
7.4
通讯作者：
Lippke S
中科院分区：
文献类型：
--
作者：
Duan YP;Liang W;Guo L;Wienert J;Si GY;Lippke S
针对多种健康行为的基于网络和基于理论的干预措施似乎是一种很有前途的方法，可以帮助出院的心脏病患者采用和维持健康的生活方式。到目前为止，还没有随机对照试验在中国冠心病康复患者中使用基于网络的干预来验证这一假设。该研究的目的是评估为期8周的网络干预在体力活动（PA）、水果和蔬菜消费（FVC）、生活方式改变、社会认知结果和健康结果方面的效果，并与等待对照组进行比较。干预内容是基于健康行动过程方法的理论。评估自我报告的数据，包括PA、FVC、健康生活方式（PA和FVC的综合）、内部资源（意图、自我效能和计划的结合）、PA和FVC行为的外部资源（社会支持）以及感知健康结果（体重指数、生活质量和抑郁）。在一项随机对照试验中，从中国某医院心脏康复中心招募了136名冠心病门诊患者。在随机化并排除不适合的参与者后，114例患者被分配到2组中的1组：(1)干预组：前4周使用PA，随后4周使用FVC；(2)等待对照组。总共进行了2次基于网络的评估，其中1次在干预开始时（T1， N=114）， 1次在8周干预结束时（T2， N=83）。入组和随访时间为2015年12月至2016年5月。基于网络的干预优于PA、FVC、PA和FVC的内部资源和FVC的外部资源的控制条件，其效应值为0.06 ~ 0.43。此外，在改善生活质量方面，干预效果显著（F1,79=16.36， P< 0.001, η2= 0.17）。当预测随访时的健康生活方式时，发现基线生活方式（比值比，OR 145.60, 95% CI 11.24-1886； P<.001）和干预（OR 21.32, 95% CI 2.40-189.20； P=.006）是显著的预测因素。FVC的内部资源介导了干预对健康生活方式的影响（R2adj= 0.29； P=.001），表明如果干预增加了行为的内部资源，更有可能采取健康生活方式。患者的心理资源，如动机、自我效能、计划、社会支持以及生活方式可以通过基于网络的PA和FVC干预来改善。这种干预丰富了心脏患者出院后积极活动、健康生活的延伸康复途径。ClinicalTrials.gov NCT01909349;https://clinicaltrials.gov/ct2/show/NCT01909349（由WebCite在http://www.webcitation.org/6pHV1A0G1存档）
Web-based and theory-based interventions for multiple health behaviors appears to be a promising approach with respect to the adoption and maintenance of a healthy lifestyle in cardiac patients who have been discharged from the hospital. Until now, no randomized controlled trials have tested this assumption among Chinese rehabilitation patients with coronary heart disease using a Web-based intervention. The study aim was to evaluate the effect of an 8-week Web-based intervention in terms of physical activity (PA), fruit and vegetable consumption (FVC), lifestyle changes, social-cognitive outcomes, and health outcomes compared with a waiting control group in Chinese cardiac patients. The intervention content was theory-based on the health action process approach. Self-reported data were evaluated, including PA, FVC, healthy lifestyle (the synthesis of PA and FVC), internal resources (combination of intention, self-efficacy, and planning), and an external resource (social support) of PA and FVC behaviors, as well as perceived health outcomes (body mass index, quality of life, and depression). In a randomized controlled trial, 136 outpatients with coronary heart disease from the cardiac rehabilitation center of a hospital in China were recruited. After randomization and exclusion of unsuitable participants, 114 patients were assigned to 1 of the 2 groups: (1) the intervention group: first 4 weeks on PA and subsequent 4 weeks on FVC and (2) the waiting control group. A total of 2 Web-based assessments were conducted, including 1 at the beginning of the intervention (T1, N=114), and 1 at the end of the 8-week intervention (T2, N=83). The enrollment and follow-up took place from December 2015 to May 2016. The Web-based intervention outperformed the control condition for PA, FVC, internal resources of PA and FVC, and an external resource of FVC, with an eta-squared effect size ranging from 0.06 to 0.43. Furthermore, the intervention effect was seen in the improvement of quality of life (F1,79=16.36, P<.001, η2=.17). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR 145.60, 95% CI 11.24-1886; P<.001) and the intervention (OR 21.32, 95% CI 2.40-189.20; P=.006) were found to be significant predictors. Internal resources for FVC mediated the effect of the intervention on the adoption of a healthy lifestyle (R2adj=.29; P=.001), indicating that if the intervention increased the internal resource of behavior, the adoption of a healthy lifestyle was more likely. Patients’ psychological resources such as motivation, self-efficacy, planning, and social support as well as lifestyle can be improved by a Web-based intervention that focuses on both PA and FVC. Such an intervention enriches extended rehabilitation approaches for cardiac patients to be active and remain healthy in daily life after hospital discharge. ClinicalTrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1)
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影响因子：
7.4
作者：
Lippke S;Fleig L;Wiedemann AU;Schwarzer R
通讯作者：
Schwarzer R
影响因子：
1.8
作者：
Schroeder, M A
通讯作者：
Schroeder, M A
影响因子：
5.1
作者：
Fleig, Lena;Lippke, Sonia;Schwarzer, Ralf
通讯作者：
Schwarzer, Ralf
影响因子：
39.2
作者：
LeFevre, Michael L.
通讯作者：
LeFevre, Michael L.
影响因子：
8
作者：
Gomez-Huelgas, R.;Jansen-Chaparro, S.;Bernal-Lopez, M. R.
通讯作者：
Bernal-Lopez, M. R.