Understanding experiences of participating in a weight loss lifestyle intervention trial: a qualitative evaluation of South Asians at high risk of diabetes
Understanding experiences of participating in a weight loss lifestyle intervention trial: a qualitative evaluation of South Asians at high risk of diabetes
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DOI：
10.1136/bmjopen-2013-004736
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Sheikh, Aziz
中科院分区：
文献类型：
--
作者：
Morrison, Zoe;Douglas, Anne;Sheikh, Aziz
目的：为了探讨的原因，招募，参与的经验和原因留在一个家庭为基础的，集群随机对照试验的营养师提供的生活方式改变干预，旨在减少南亚人肥胖的高风险发展diabetes.Design：定性研究使用叙事访谈的一个有目的的样本的试验参与者完成干预。数据进行了主题分析。设置：干预是在苏格兰进行的，并导致体重适度下降，但没有统计学上减少糖尿病的发病率。参与者：我们进行了21个叙事访谈24名参与者（20名试验参与者和4名家庭志愿者）。结果：许多参与者参与的动机是因为：已知的糖尿病家族史，以及更好地了解糖尿病相关风险对自己和家人健康的愿望;减轻这些风险的方法，并从个性化监测中获益。基于家庭的干预措施，参与者选择的语言沟通和营养师的连续性支持他们继续参与试验。食物选择的适应最初是由参与者提供的，尽管据报道，社会和信仰责任是坚持商定饮食目标的重要障碍。许多参与者报告说，由于工作时间长、工作对体力要求高和家务负担重，他们很难增加身体活动水平;苏格兰的气候具有挑战性，因此不愿意在户外锻炼。虽然参与者对参与有强烈的个人兴趣，并认为营养师提供的信息很有用，尽管如此，他们仍努力将饮食和运动建议纳入日常生活。特别是，增加体育锻炼被认为是一种额外的负担，在某些情况下是无法实现的。需要考虑加强和支持以社区为基础的生活方式干预措施，以帮助克服更广泛的社会和环境因素。
Objective: To explore the reasons for enrolling, experiences of participating and reasons for remaining in a family-based, cluster randomised controlled trial of a dietitian-delivered lifestyle modification intervention aiming to reduce obesity in South Asians at high risk of developing diabetes.Design: Qualitative study using narrative interviews of a purposive sample of trial participants following completion of the intervention. Data were thematically analysed.Setting: The intervention was conducted in Scotland and resulted in a modest decrease in weight, but did not statistically reduce the incidence of diabetes.Participants: We conducted 21 narrative interviews with 24 participants (20 trial participants and four family volunteers).Results: Many participants were motivated to participate because of: known family history of diabetes and the desire to better understand diabetes-related risks to their own and their family's health; ways to mitigate these risks and to benefit from personalised monitoring. Home-based interventions, communication in the participant's chosen language(s) and continuity in dietitians supported their continuing engagement with the trial. Adaptations in food choices were initially accommodated by participants, although social and faith-based responsibilities were reported as important barriers to persevering with agreed dietary goals. Many participants reported that increasing their level of physical activity was difficult given their long working hours, physically demanding employment and domestic commitments; this being compounded by Scotland's challenging climate and a related reluctance to exercise in the outdoors.Conclusions: Although participants had strong personal interests in participation and found the information provided by dietitians useful, they nonetheless struggled to incorporate the dietary and exercise recommendations into their daily lives. In particular, increasing levels of physical exercise was described as an additional and in some cases unachievable burden. Consideration needs to be given to strengthening and supporting lifestyle interventions with community-based approaches in order to help overcome wider social and environmental factors.