Randomized-controlled trial of a computer-tailored print based intervention to encourage nutritional and physical activity changes in the community

目的：基于打印的程序可以被公共卫生用来干预新的人群，如相对年轻的人群、男性和工人，从而提高身体活动水平，降低心血管疾病的风险。这项研究的目的是检验一项基于打印的计划的长期效果，该计划使用计算机、互联网和邮件来刺激社区营养和身体活动的变化。方法：从4个城市招募健康成人281名，随机分为3组：(1)1封邮件（仅设定目标，n=81）、（2)3封邮件组（3封邮件3次反馈，n=90）、(3)4封邮件4次反馈，n=91）。所有干预组的受试者都监测他们的日常步数，并使用邮寄的材料制定行动计划。此外，3个邮件组完成了目标实现和应对感知障碍的任务。另外，4个邮件组完成了预防复吸的任务。结果测量：每日步数，能量摄入，体重，体重指数，总胆固醇，甘油三酯，HDL, HbAlc。在基线、2个月和14个月收集所有测量数据。结果：参与者的平均年龄为50.9±11.2岁（27%为男性，46%为在职）。三组间所有结局指标均无明显差异。但在2个月和14个月时，各组的总能量摄入量、谷物和糖果含量均有所下降。14个月时，所有组的HDL-C均升高。结论：不同邮寄内容及邮寄频率对干预效果无影响。我们量身定制的打印干预对食物摄入和心血管疾病的危险因素有效，但对身体活动无效。这种基于计算机定制的打印程序使用信息技术对社区环境中的生活方式改变是有效的。

OBJECTIVE: Print based program can be used by public health to intervene with new segments, such as comparatively young people, males, and workers, so as to improve the level of physical activity and decrease the risk of cardiovascular disease. The purpose of this study was to examine the long-term effect of a print based program using the computer, internet and mail to stimulate nutritional and physical activity changes in the community. METHODS: Healthy adults (281), recruited in four cities, were allocated randomly to three groups: (1) 1 mail (goal setting only, n=81), (2) 3 mail group (3 mails and 3 feedbacks, n=90), (3) 4 mail group (4 mails and 4 feedbacks, n=91). The subjects in all intervention groups monitored their daily steps and created action plans using mailed materials. Additionally, 3 mail group completed tasks of goal attainment and coping with perceived barrier. Additionally, 4 mail group completed tasks of relapse prevention.OUTCOME MEASURES: Daily steps, Energy intake, body weight, body mass index, total cholesterol, triglyceride, HDL, HbAlc. All measures were collected at baseline, 2 month and 14 month.RESULTS: The mean age of the participants was 50.9±11.2 years (27% male; 46% employed). There was no observable difference in all outcome measures among the three groups. However, Total energy intake, Cereals and Confectionery in all groups decreased at 2 month and 14 month. HDL-C increased in all groups at 14 month.CONCLUSION : The different contents and the frequency of mailing did not influence the intervention effects. Our tailored print intervention was effective in food intake and risk factor of CVD and was not effective in physical activity. This computer-tailored print based program using information technology was effective for lifestyle modification in the community setting.