Development of lifestyle modification program for community based health care services.

目的;比较行为干预计划（BIP）和传统健康教育计划（CHP）在促进中年人体育锻炼和健康饮食习惯以及改善心血管疾病危险因素方面的效果。方法;100名受试者被随机分配到BIP组或CHP组。两组受试者均参加相同的干预方案（每月2小时，为期4个月）。以行为理论和社会认知理论为基础，运用行为策略(如：（目标设定、自我监督、奖励和社会支持）。CHP由生活方式相关疾病、运动和营养讲座组成。主要结果是每日步行步数、自我报告的身体活动和食物（总能量、脂肪和蔬菜）摄入量。次要结果是BMI、腰围、血压和血液化学物质。数据收集在基线、干预结束、干预结束后6个月和12个月进行。结果;方差分析（anova）检验显示，组与时间之间的每日步行步数和闲暇时间的身体活动有显著的相互作用。在干预结束和随访期间，两项指标在BIP组均明显高于CHP组。任何食物摄入都没有显著的相互作用。次要结果均未显示出显著的相互作用。然而，肥胖女性（BMI bbbb24）的亚组分析显示出显著的相互作用，每项次要结局都有显著更大的下降。在BIP组中，HOMA-IR的变化与休闲时间体力活动的变化呈负相关。结论;与CHP相比，BIP对中年人身体活动的改善作用更大，并改善了肥胖妇女的肥胖和葡萄糖代谢。

Purpose ; To compare the effects of a behavioral intervention program(BIP) and a conventional health education program(CHP) on promoting physical activity and healthy dietary habits, and improving risk factors for cardiovascular diseases in middle-aged people.Method ; One hundred subjects were randomly assigned to either the BIP or CHP group. The subjects in both groups participated in the same intervention protocol(2-hr monthly group sessions over 4 months). The BIP was based on behavior theory and social cognitive theory, and constructed using behavioral strategies(e.g., goal setting, self-monitoring, rewards, and social support). The CHP was constructed of lectures on lifestyle-related diseases, exercise, and nutrition. Primary outcomes were number of daily walking steps, self-reported physical activity, and food(total energy, fat, and vegetable) intakes. Secondary outcomes were BMI, waist circumference, blood pressure, and blood chemicals. The data collection was done at the baseline, the end of the intervention, 6 months and 12 months after the end of the intervention.Results ; An ANOVA-test showed a significant interaction between group and time for the number of daily walking steps and a leisure time physical activity. Both indices showed significantly larger increases in the BIP group than in the CHP group at the end of the intervention and during follow-up period. There were no significant interactions for any food intakes. None of the secondary outcomes showed a significant interaction. However, subgroup analysis of obese women(BMI>24) showed significant interactions which showed significantly greater decreases in every secondary outcome. The change in HOMA-IR negatively correlated with the change in leisure-time physical activity in the BIP group.Conclusion ; The BIP facilitated greater improvement in physical activity than the CHP in middle-aged people and improved obesity and glucose metabolism in obese women.