Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study.
Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study.
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DOI：
10.2196/resprot.5861
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发表时间：
2016-10-14
影响因子：
1.7
通讯作者：
Horwath CC
中科院分区：
文献类型：
--
作者：
Boucher S;Edwards O;Gray A;Nada-Raja S;Lillis J;Tylka TL;Horwath CC
中年女性有体重增加及相关合并症的风险。刻意限制食物摄入（节食）可在短期内减轻体重，但在长期体重管理方面大多不成功。预防体重增加的两种有前景的方法是直觉饮食（即根据饥饿和饱腹感信号进食）以及提高心理灵活性（即接纳与承诺疗法[ACT]的目标）。
这项初步研究调查了“身心与食物”这一基于网络的预防体重增加干预原型的使用情况、可接受性和可行性，该原型教授直觉饮食和心理灵活性技能。
参与者为40名超重女性（平均年龄44.8岁[标准差，SD，3.06]，平均体重指数[BMI]32.9[SD 6.01]kg/m²，平均直觉饮食量表[IES - 1]总分53.4[SD 7.46]，被归类为低于平均水平），她们是从新西兰达尼丁的普通人群中招募的。使用谷歌分析评估模块完成情况和研究网站指标。通过保存到安全在线数据库的条目确定在线自我监测工具的使用情况。干预后评估干预的可接受性。在干预前、干预后以及干预后3个月评估BMI、直觉饮食、暴食、心理灵活性以及一般的身心健康状况。
在参与研究的40名女性中，12人（30%）完成了全部12个模块（中位数为7.5个[四分位距，IQR，2 - 12]模块），4人（10%）在干预期的全部14周都使用了自我监测工具（中位数为3周[IQR 1 - 9周]）。在完成干预后评估的26名女性中，大多数女性认为“身心与食物”有用（20/26，77%）、易于使用（17/25，68%）并且喜欢该干预措施（22/25，88%）。从干预前到干预后，组内直觉饮食（IES - 2总分P <.001；所有IES - 2子量表分数：P ≤.01）、心理灵活性（P =.01）和一般心理健康（P <.001）有统计学意义的增加，暴食情况有显著减少（P =.01）。在3个月的随访中，IES - 2的改善得以维持，暴食（P <.001）和一般心理健康（P =.03）有进一步改善，心理灵活性有进一步改善的轻微但不显著的趋势（P =.06）。从干预前到干预后以及从干预后到3个月随访，BMI在组内没有显著变化（分别为P =.46和P =.93）。
“身心与食物”基于网络的原型干预措施对中年女性有吸引力，可能是帮助女性学习直觉饮食和ACT技能、减少暴食并在3个月内维持体重的有用工具。在随机对照试验中测试该在线干预措施之前，需要进一步改进用户体验和提高参与度。
Middle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]). This pilot study investigated the usage, acceptability, and feasibility of “Mind, Body, Food,” a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills. Participants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention. Of the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated “Mind, Body, Food” as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2 total score P<.001; all IES-2 subscale scores: P ≤.01), psychological flexibility (P=.01), and general mental health (P<.001) as well as significant decreases in binge eating (P=.01). At the 3-month follow-up, IES-2 improvements were maintained, and there were further improvements in binge eating (P<.001) and general mental health (P=.03), and a marginal yet nonsignificant tendency for further improvement in psychological flexibility (P=.06). There were no significant within-group changes in BMI from pre- to postintervention and postintervention to 3-month follow-up (P=.46 and P=.93, respectively). The “Mind, Body, Food” prototype Web-based intervention is appealing to middle-aged women and may be a useful tool to help women learn intuitive eating and ACT skills, reduce binge eating, and maintain weight over 3 months. Further work to improve the user experience and engagement is required before testing the online intervention in a randomized controlled trial.