PDF(Pubmed)
Abstract：
OBJECTIVE: Although life events are clearly important to health, most of the scientific focus has been on baseline life events that occur prior to a study. Life events that occur after enrolment, that is, interval life events, have had almost no attention. The aim of this analysis of data was to develop a method for measuring interval life events that could be used in clinical trials and other longitudinal studies.
METHODS: Small Changes and Lasting Effects (SCALE) was a 12-month weight-loss randomised controlled trial (RCT). This was an analysis of the SCALE follow-up data.
METHODS: Healthcare networks, outpatient clinics and community churches in the South Bronx and Harlem areas of New York City.
METHODS: Overweight black and Latino adults. This analysis focuses on the 330 of the 405 patients who had >4 weeks of follow-up with at least one perceived stress score (PSS).
METHODS: The SCALE RCT was published elsewhere and involved positive affect and self-affirmation to increase behaviour change.
RESULTS: 5% weight loss.
RESULTS: Over 12 months, up to 27 follow-ups were conducted that evaluated interval life events, eating and physical activity behaviour, weight and perceived stress. During these follow-ups, participants were asked two open-ended questions to capture interval life events. The interval life events were qualitatively coded into categories. The interval life events categories were compared with interval monthly measures of perceived stress using the 4-item PSS scale.
RESULTS: During the interval follow-ups for the RCT, 70.6% of the 330 patients reported at least one interval life event, which occurred during a median of 15 follow-ups (95% CI: 5 to 24). The median number of interval events was 2 (95% CI: 0 to 8): 30.6% reported their own illness; 22%, death or bereavement; 21.8%, illness in the family and 13.1%, family conflicts. The mean perceived stress score (PSS-4) assessed over the year of follow-up was 3.2±2.7. Mean perceived stress (PSS-4) increased, especially for interval financial events, major conflict with a partner and unemployment, but by less for deaths, family illness and family conflict. Participants with the most interval life events had the greatest increase in interval perceived stress (p<0.0001). Of note, neither high baseline perceived stress (PSS-10 >20) nor baseline depression (Patient Health Questionnaire-9 >10) were associated with higher interval life events (p>0.05); but those with lower social support had more events. However, those with either depression or stress had higher interval stress responses. Most participants had neither baseline nor interval events, and the percentage with both was small so that baseline events did not predict subsequent perceived stress.
CONCLUSIONS: This method provides a straightforward method of assessing interval life events, by asking two open-ended questions, that can be coded in a simple categorical framework. Such events can affect outcomes in longitudinal studies and trials in part by increasing perceived stress. This framework moves beyond the events identified as important in the 1950s and recognises that specific life events may have significantly different life impacts in different individuals.
BACKGROUND: NCT01198990; Post-results.
METHODS: Small Changes and Lasting Effects (SCALE) was a 12-month weight-loss randomised controlled trial (RCT). This was an analysis of the SCALE follow-up data.
METHODS: Healthcare networks, outpatient clinics and community churches in the South Bronx and Harlem areas of New York City.
METHODS: Overweight black and Latino adults. This analysis focuses on the 330 of the 405 patients who had >4 weeks of follow-up with at least one perceived stress score (PSS).
METHODS: The SCALE RCT was published elsewhere and involved positive affect and self-affirmation to increase behaviour change.
RESULTS: 5% weight loss.
RESULTS: Over 12 months, up to 27 follow-ups were conducted that evaluated interval life events, eating and physical activity behaviour, weight and perceived stress. During these follow-ups, participants were asked two open-ended questions to capture interval life events. The interval life events were qualitatively coded into categories. The interval life events categories were compared with interval monthly measures of perceived stress using the 4-item PSS scale.
RESULTS: During the interval follow-ups for the RCT, 70.6% of the 330 patients reported at least one interval life event, which occurred during a median of 15 follow-ups (95% CI: 5 to 24). The median number of interval events was 2 (95% CI: 0 to 8): 30.6% reported their own illness; 22%, death or bereavement; 21.8%, illness in the family and 13.1%, family conflicts. The mean perceived stress score (PSS-4) assessed over the year of follow-up was 3.2±2.7. Mean perceived stress (PSS-4) increased, especially for interval financial events, major conflict with a partner and unemployment, but by less for deaths, family illness and family conflict. Participants with the most interval life events had the greatest increase in interval perceived stress (p<0.0001). Of note, neither high baseline perceived stress (PSS-10 >20) nor baseline depression (Patient Health Questionnaire-9 >10) were associated with higher interval life events (p>0.05); but those with lower social support had more events. However, those with either depression or stress had higher interval stress responses. Most participants had neither baseline nor interval events, and the percentage with both was small so that baseline events did not predict subsequent perceived stress.
CONCLUSIONS: This method provides a straightforward method of assessing interval life events, by asking two open-ended questions, that can be coded in a simple categorical framework. Such events can affect outcomes in longitudinal studies and trials in part by increasing perceived stress. This framework moves beyond the events identified as important in the 1950s and recognises that specific life events may have significantly different life impacts in different individuals.
BACKGROUND: NCT01198990; Post-results.
摘要：
目标：虽然生活事件对健康显然很重要，大多数科学关注的焦点是在研究之前发生的基线生活事件.入学后发生的生活事件，也就是说,间歇生活事件，几乎没有注意。这种数据分析的目的是开发一种测量间隔期生活事件的方法，该方法可用于临床试验和其他纵向研究。
方法：小变化和持久效应（SCALE）是一项为期12个月的减重随机对照试验（RCT）。这是对SCALE后续数据的分析。
方法：医疗保健网络，纽约市南布朗克斯和哈莱姆地区的门诊诊所和社区教堂。
方法：超重的黑人和拉丁裔成年人。该分析集中于405名患者中的330名，这些患者进行了>4周的随访，至少有一个感知压力评分（PSS）。
方法：SCALERCT在其他地方发表，涉及积极的情感和自我肯定以增加行为改变。
结果：重量损失5%。
结果：超过12个月，进行了多达27次随访，评估了间隔期生活事件，饮食和身体活动行为，体重和感知压力。在这些后续行动中,参与者被问及两个开放式问题,以记录间隔期生活事件.间歇生活事件被定性地分类。使用4项PSS量表将间歇生活事件类别与间隔每月感知压力的测量值进行比较。
结果：在RCT的间隔随访期间，330例患者中有70.6%报告了至少一个间隔期生活事件，发生在15次随访的中位数（95%CI：5至24）。间隔事件的中位数为2（95％CI：0至8）：30.6％报告了自己的病情；22％，死亡或丧亲；21.8%，家庭中的疾病和13.1％，家庭冲突。随访一年中评估的平均感知压力评分（PSS-4）为3.2±2.7。平均感知压力(PSS-4)增加，特别是对于间隔金融事件，与伴侣的重大冲突和失业，但是对于死亡来说更少，家庭疾病和家庭冲突。间隔生活事件最多的参与者的间隔感知压力增加最大（p<0.0001）。值得注意的是，高基线感知压力(PSS-10>20)和基线抑郁(患者健康问卷-9>10)均不与较高的间隔性生活事件相关(p>0.05);但社会支持较低的患者发生的事件较多.然而,抑郁或应激者的应激反应间隔较高。大多数参与者既没有基线事件，也没有间隔事件，并且两者的百分比都很小，因此基线事件无法预测随后的感知压力。
结论：该方法提供了一种评估间隔生活事件的简单方法，通过问两个开放式问题，可以在一个简单的分类框架中编码。这些事件可以部分地通过增加感知压力来影响纵向研究和试验的结果。该框架超越了1950年代确定的重要事件，并认识到特定的生活事件可能对不同的人产生明显不同的生活影响。
背景：NCT01198990；后期结果。
方法：小变化和持久效应（SCALE）是一项为期12个月的减重随机对照试验（RCT）。这是对SCALE后续数据的分析。
方法：医疗保健网络，纽约市南布朗克斯和哈莱姆地区的门诊诊所和社区教堂。
方法：超重的黑人和拉丁裔成年人。该分析集中于405名患者中的330名，这些患者进行了>4周的随访，至少有一个感知压力评分（PSS）。
方法：SCALERCT在其他地方发表，涉及积极的情感和自我肯定以增加行为改变。
结果：重量损失5%。
结果：超过12个月，进行了多达27次随访，评估了间隔期生活事件，饮食和身体活动行为，体重和感知压力。在这些后续行动中,参与者被问及两个开放式问题,以记录间隔期生活事件.间歇生活事件被定性地分类。使用4项PSS量表将间歇生活事件类别与间隔每月感知压力的测量值进行比较。
结果：在RCT的间隔随访期间，330例患者中有70.6%报告了至少一个间隔期生活事件，发生在15次随访的中位数（95%CI：5至24）。间隔事件的中位数为2（95％CI：0至8）：30.6％报告了自己的病情；22％，死亡或丧亲；21.8%，家庭中的疾病和13.1％，家庭冲突。随访一年中评估的平均感知压力评分（PSS-4）为3.2±2.7。平均感知压力(PSS-4)增加，特别是对于间隔金融事件，与伴侣的重大冲突和失业，但是对于死亡来说更少，家庭疾病和家庭冲突。间隔生活事件最多的参与者的间隔感知压力增加最大（p<0.0001）。值得注意的是，高基线感知压力(PSS-10>20)和基线抑郁(患者健康问卷-9>10)均不与较高的间隔性生活事件相关(p>0.05);但社会支持较低的患者发生的事件较多.然而,抑郁或应激者的应激反应间隔较高。大多数参与者既没有基线事件，也没有间隔事件，并且两者的百分比都很小，因此基线事件无法预测随后的感知压力。
结论：该方法提供了一种评估间隔生活事件的简单方法，通过问两个开放式问题，可以在一个简单的分类框架中编码。这些事件可以部分地通过增加感知压力来影响纵向研究和试验的结果。该框架超越了1950年代确定的重要事件，并认识到特定的生活事件可能对不同的人产生明显不同的生活影响。
背景：NCT01198990；后期结果。
