背景:在观察性研究中,合作伙伴支持与更好的减肥结果相关,但随机试验显示包括伴侣在内的结果好坏参半.不清楚的是,向夫妇传授沟通技巧是否会改善试图减肥的人的减肥效果(指数参与者)。
目的:比较合作伙伴辅助干预与仅参与者体重管理计划对24个月体重减轻的疗效。
方法:这项基于社区的研究在麦迪逊进行,WI.如果指数参与者符合肥胖指导标准,他们就有资格接受减肥咨询,年龄在18-74岁之间,和一个搭档住在一起,并且没有减肥的医学禁忌症;伴侣年龄在18-74岁之间,体重不足。夫妇以1:1的比例随机分配给伴侣辅助或仅参与者的干预。两组的指数参与者都接受了基于证据的体重管理计划。在伴侣辅助的手臂上,合作伙伴参加了一半的干预会议,夫妇接受了沟通技巧的培训。主要结果是24个月时的指数参与者体重,由蒙面人员评估;次要结局是24个月自我报告的热量摄入和活动追踪器评估的平均每日步数.根据意向治疗原则,使用一般线性混合模型比较这些结果的组间差异。
结果:在分配给伴侣辅助(n=115)或仅参与者干预(n=116)的夫妇中,大多数指数参与者确定为女性(67%)和非西班牙裔白人(87%)。平均基线年龄为47.27岁(SD11.51岁),体重为106.55kg(SD19.41kg)。估计24个月的平均体重减轻在伴侣辅助(2.66kg)和仅参与者的手臂(2.89kg)中相似(估计的平均差异,0.23千克[95%CI,-1.58,2.04千克],p=0.80)。24个月平均每日热量摄入没有差异(估计平均差50cal[95%CI:-233,132cal],p=0.59)或步长(估计平均差806步长[95%CI:-1675,64步长],p=0.07)。报告至少有可能归因于干预措施的不良事件的参与者的百分比没有差异(合作伙伴协助:9%,仅限参与者,3%,p=0.11)。
结论:伙伴辅助和个体体重管理干预在指数参与者中导致相似的结果。
背景:Clinicaltrials.govNCT03801174,2019年1月11日。
BACKGROUND: Partner support is associated with better weight loss outcomes in observational studies, but randomized trials show mixed results for including partners. Unclear is whether teaching communication skills to couples will improve weight loss in a person attempting weight loss (index participant).
OBJECTIVE: To compare the efficacy of a partner-assisted intervention versus participant-only weight management program on 24-month weight loss.
METHODS: This community-based study took place in Madison, WI. Index participants were eligible if they met obesity guideline criteria to receive weight loss counseling, were aged 18-74 years, lived with a partner, and had no medical contraindications to weight loss; partners were aged 18-74 years and not underweight. Couples were randomized 1:1 to a partner-assisted or participant-only intervention. Index participants in both arms received an evidence-based weight management program. In the partner-assisted arm, partners attended half of the intervention sessions, and couples were trained in communication skills. The primary outcome was index participant weight at 24 months, assessed by masked personnel; secondary outcomes were 24-month self-reported caloric intake and average daily steps assessed by an activity tracker. General linear mixed models were used to compare group differences in these outcomes following intent-to-treat principles.
RESULTS: Among couples assigned to partner-assisted (n = 115) or participant-only intervention (n = 116), most index participants identified as female (67%) and non-Hispanic White (87%). Average baseline age was 47.27 years (SD 11.51 years) and weight was 106.55 kg (SD 19.41 kg). The estimated mean 24-month weight loss was similar in the partner-assisted (2.66 kg) and participant-only arms (2.89 kg) (estimated mean difference, 0.23 kg [95% CI, -1.58, 2.04 kg], p=0.80). There were no differences in 24-month average daily caloric intake (estimated mean difference 50 cal [95% CI: -233, 132 cal], p=0.59) or steps (estimated mean difference 806 steps [95% CI: -1675, 64 steps], p=0.07). The percentage of participants reporting an adverse event with at least possible attribution to the intervention did not differ by arm (partner-assisted: 9%, participant-only, 3%, p = 0.11).
CONCLUSIONS: Partner-assisted and individual weight management interventions led to similar outcomes in index participants.
BACKGROUND: Clinicaltrials.gov NCT03801174, January 11, 2019.