The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.
The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.
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DOI：
10.1186/s12966-018-0654-8
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发表时间：
2018-02-27
期刊：
影响因子：
--
通讯作者：
Kolehmainen M
中科院分区：
文献类型：
--
作者：
Järvelä-Reijonen E;Karhunen L;Sairanen E;Muotka J;Lindroos S;Laitinen J;Puttonen S;Peuhkuri K;Hallikainen M;Pihlajamäki J;Korpela R;Ermes M;Lappalainen R;Kolehmainen M
内在动机和良好的心理能力是成功改变饮食相关行为的重要因素。因此，我们调查了一般接受和承诺疗法(ACT)是否影响报告的饮食行为和饮食质量，以及基线感知压力是否缓和了干预效果。芬兰三个城市非盲法随机对照试验的二次分析。有心理障碍和超重或肥胖的工作年龄成年人分为三组：(1)面对面治疗(n = 70；由一名心理学家领导的六组治疗)；(2)基于治疗的移动治疗(n = 78；一个小组治疗和手机应用程序)；和(3)对照组(n = 71，仅测量)。在基线时，参与者(n = 219，85%女性)的平均体重指数为31.30 kg/m2(SD = 2.9)，平均年龄为49.5岁(SD = 7.4)。在干预前8周(基线)、基线后10周(干预后)和基线后36周(随访)进行的测量包括临床测量、饮食行为问卷(IES-1、TFEQ-R18、HTAS、eCSI 2.0、REBS)、饮食质量(IDQ)、饮酒量(AUDIT-C)、感知压力(PSS)和48小时饮食回忆。采用分层线性模型(Wald检验)分析组间变化的差异。X组时间交互作用显示，直觉进食(IES-1)的子成分，即出于身体原因而不是情感原因进食，在两个基于行为的两组中增加(p = .019)，在面对面组中，TFEQ-R18的子成分，即不受控制的进食，在面对面组中减少(p = .020)，在移动组中，健康和味觉态度(HTA)的子成分，即用食物作为奖励，减少(p = .048)；而进食能力(eCSI2.0)的两个子成分，即食物接受度(p = .048)和进食行为调节(REBS)的两个子成分，即综合和识别调节(p = .003，p = .023)，在面对面组都增加了。从基线到随访，基线感知的压力并没有缓和对饮食行为的这些特定特征的影响。饮食措施没有发现统计上的显著影响。以行动为基础的干预措施，通过小组会议或移动应用程序提供，显示出对报告的饮食行为的有益影响。然而，饮食行为的有益影响并没有伴随着饮食的平行变化，这表明如果饮食变化是有针对性的，基于ACT的干预应该包括营养咨询。ClinicalTrials.gov(NCT01738256)，2012年8月17日注册。本文的在线版本(10.1186/s12966-0180654-8)包含向授权用户提供的补充材料。
Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; only the measurements). At baseline, the participants’ (n = 219, 85% females) mean body mass index was 31.3 kg/m2 (SD = 2.9), and mean age was 49.5 years (SD = 7.4). The measurements conducted before the 8-week intervention period (baseline), 10 weeks after the baseline (post-intervention), and 36 weeks after the baseline (follow-up) included clinical measurements, questionnaires of eating behavior (IES-1, TFEQ-R18, HTAS, ecSI 2.0, REBS), diet quality (IDQ), alcohol consumption (AUDIT-C), perceived stress (PSS), and 48-h dietary recall. Hierarchical linear modeling (Wald test) was used to analyze the differences in changes between groups. Group x time interactions showed that the subcomponent of intuitive eating (IES-1), i.e., Eating for physical rather than emotional reasons, increased in both ACT-based groups (p = .019); the subcomponent of TFEQ-R18, i.e., Uncontrolled eating, decreased in the Face-to-face group (p = .020); the subcomponent of health and taste attitudes (HTAS), i.e., Using food as a reward, decreased in the Mobile group (p = .048); and both subcomponent of eating competence (ecSI 2.0), i.e., Food acceptance (p = .048), and two subcomponents of regulation of eating behavior (REBS), i.e., Integrated and Identified regulation (p = .003, p = .023, respectively), increased in the Face-to-face group. Baseline perceived stress did not moderate effects on these particular features of eating behavior from baseline to follow-up. No statistically significant effects were found for dietary measures. ACT-based interventions, delivered in group sessions or by mobile app, showed beneficial effects on reported eating behavior. Beneficial effects on eating behavior were, however, not accompanied by parallel changes in diet, which suggests that ACT-based interventions should include nutritional counseling if changes in diet are targeted. ClinicalTrials.gov (NCT01738256), registered 17 August, 2012. The online version of this article (10.1186/s12966-018-0654-8) contains supplementary material, which is available to authorized users.
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