Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance.
Comparison of an alternative schedule of extended care contacts to a self-directed control: a randomized trial of weight loss maintenance.
复制标题
DOI：
10.1186/s12966-017-0564-1
复制
发表时间：
2017-08-15
期刊：
影响因子：
--
通讯作者：
Lewis CE
中科院分区：
文献类型：
--
作者：
Dutton GR;Gowey MA;Tan F;Zhou D;Ard J;Perri MG;Lewis CE
对肥胖的行为干预产生临床意义的体重减轻，但治疗后体重反弹是常见的。延长护理计划减轻体重反弹和改善减肥维持。然而，人们对提供长期护理的最有效方法知之甚少，包括联系时间表。我们比较了在先前体重减轻≥5%的个体中，采用非传统集群式治疗计划的延长护理计划和自我指导计划的12个月体重恢复情况。在最初16周的行为性肥胖治疗中体重减轻≥5%的参与者（N = 108，平均年龄= 51.6岁，平均体重= 92.6 kg， 52%为非洲裔美国人，95%为女性）被随机分为两组，为期12个月的延长护理试验。集群活动条件包括12个以小组为基础的访问，以3周、4周为集群。自我指导条件包括提供相同的印刷干预材料，但没有额外的治疗访问。该研究于2011年至2015年在美国一家学术医疗中心进行。在随机化之前，参与者平均减轻了- 7.55±3.04 kg。随机分配到12个月集群运动计划的参与者体重恢复（0.35±4.62 kg）显著低于自我指导的参与者（2.40±3.99 kg），协变量调整后组间差异为2.28 kg （p = 0.0154）。这对应于在群集运动和自我指导条件下分别维持87%和64%的体重减轻，在协变量调整后，组间差异显着为29%的体重减轻维持，p = 0.0396。在群集运动治疗计划的初步测试中，这种新颖的方法有效地促进了12个月的减肥维持。未来的试验应直接比较集群活动与传统的（如每月）延长护理计划。Clinicaltrials.gov NCT02487121。2015年6月26日注册（追溯注册）
Behavioral interventions for obesity produce clinically meaningful weight loss, but weight regain following treatment is common. Extended care programs attenuate weight regain and improve weight loss maintenance. However, less is known about the most effective ways to deliver extended care, including contact schedules. We compared the 12-month weight regain of an extended care program utilizing a non-conventional, clustered campaign treatment schedule and a self-directed program among individuals who previously achieved ≥5% weight reductions. Participants (N = 108; mean age = 51.6 years; mean weight = 92.6 kg; 52% African American; 95% female) who achieved ≥5% weight loss during an initial 16-week behavioral obesity treatment were randomized into a 2-arm, 12-month extended care trial. A clustered campaign condition included 12 group-based visits delivered in three, 4-week clusters. A self-directed condition included provision of the same printed intervention materials but no additional treatment visits. The study was conducted in a U.S. academic medical center from 2011 to 2015. Prior to randomization, participants lost an average of −7.55 ± 3.04 kg. Participants randomized to the 12-month clustered campaign program regained significantly less weight (0.35 ± 4.62 kg) than self-directed participants (2.40 ± 3.99 kg), which represented a significant between-group difference of 2.28 kg (p = 0.0154) after covariate adjustments. This corresponded to maintaining 87% and 64% of lost weight in the clustered campaign and self-directed conditions, respectively, which was a significant between-group difference of 29% maintenance of lost weight after covariate adjustments, p = 0.0396. In this initial test of a clustered campaign treatment schedule, this novel approach effectively promoted 12-month maintenance of lost weight. Future trials should directly compare the clustered campaigns with conventional (e.g., monthly) extended care schedules. Clinicaltrials.gov NCT02487121. Registered 06/26/2015 (retrospectively registered)
登录
查看更多内容
DOI：
10.1136/bmj.g2646
发表时间：
2014-05-14
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Dombrowski SU;Knittle K;Avenell A;Araújo-Soares V;Sniehotta FF
通讯作者：
Sniehotta FF
DOI：
10.1002/oby.20967
发表时间：
2015-01
期刊：
Obesity (Silver Spring, Md.)
影响因子：
--
作者：
MacLean PS;Wing RR;Davidson T;Epstein L;Goodpaster B;Hall KD;Levin BE;Perri MG;Rolls BJ;Rosenbaum M;Rothman AJ;Ryan D
通讯作者：
Ryan D
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
影响因子：
120.7
作者：
Svetkey, Laura P.;Stevens, Victor J.;Aicher, Kathleen
通讯作者：
Aicher, Kathleen
影响因子：
5.1
作者：
Levy, Rona L.;Jeffery, Robert W.;Yatsuya, Hiroshi
通讯作者：
Yatsuya, Hiroshi