Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial.
Extended-care programs for weight management in rural communities: the treatment of obesity in underserved rural settings (TOURS) randomized trial.
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DOI：
10.1001/archinte.168.21.2347
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发表时间：
2008-11-24
影响因子：
--
通讯作者：
Martin, A. Daniel
中科院分区：
文献类型：
--
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
美国农村地区的肥胖率、久坐不动的生活方式和相关的慢性病比非农村地区更高，但研究人员对农村社区肥胖的管理却很少关注。比较2个扩展护理计划与教育对照组的体重管理。来自农村社区的234名肥胖妇女完成了最初6个月的减肥计划，她们被随机分配到延长护理组，通过电话咨询或面对面会议提供服务，或教育对照组。在六个医疗服务不足的农村县的合作推广服务办公室作为试验场所。研究于2003年6月至2007年5月进行。扩展护理方案需要在26个双周会议提供解决问题的咨询。对照组的参与者收到了26份包含体重控制建议的双周通讯。体重相对于随机化的变化。研究入组时的平均体重为96.4 kg。最初6个月干预期间的平均体重减轻为10.0 kg。随机分组一年后，电话和面对面条件下的参与者体重恢复（平均值± SE分别为1.3 ± 0.7和1.2 ± 0.6 kg）低于教育对照组（3.7 ± 0.6 kg; Ps = 0.02和0.03）。更大的坚持行为体重管理策略介导的扩展护理咨询的有益效果，成本分析表明，电话咨询是更便宜的面对面的干预。通过电话或面对面会议提供的延长护理与单独的教育相比，改善了一年的减肥维持。电话咨询是长期体重管理的有效和具有成本效益的选择。通过合作推广服务的现有基础设施提供生活方式干预措施是将研究转化为获得预防性保健服务有限的农村社区的可行手段。ClinicalTrials.gov编号，NCT 00201006。
Rural counties in the U.S. have higher rates of obesity, sedentary lifestyle, and associated chronic diseases than non-rural areas, yet the management of obesity in rural communities has received little attention from researchers. To compare 2 extended-care programs for weight management with an education control group. 234 obese women from rural communities who completed an initial 6-month weight-loss program were randomized to extended-care, delivered via telephone counseling or face-to-face sessions, or to an education control group. Cooperative Extension Service offices in six medically underserved rural counties served as venues for the trial. The study was conducted from June 2003 to May 2007. The extended-care programs entailed problem-solving counseling delivered in 26 biweekly sessions. Control group participants received 26 biweekly newsletters containing weight-control advice. Change in weight from randomization. Mean weight at study entry was 96.4 kg. Mean weight loss during the initial 6-month intervention was 10.0 kg. One year after randomization, participants in the telephone and face-to-face conditions regained less weight (means ± SE = 1.3 ± 0.7 and 1.2 ± 0.6 kg, respectively) than those in the education control group (3.7 ± 0.6 kg; Ps = 0.02 and 0.03). The beneficial effects of extended-care counseling were mediated by greater adherence to behavioral weight-management strategies, and cost analyses indicated that telephone counseling was less expensive than face-to-face intervention. Extended care delivered either by telephone or face-to-face sessions improved the one-year maintenance of lost weight compared to education alone. Telephone counseling constitutes an effective and cost-efficient option for long-term weight management. Delivering lifestyle interventions via the existing infrastructure of the Cooperative Extension Service represents a viable means of research translation into rural communities with limited access to preventive health services. ClinicalTrials.gov number, NCT00201006.
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影响因子：
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