背景:世界卫生组织呼吁通过在人群中促进健康的生活方式来解决非传染性疾病(NCDs)日益增加的负担。关于病人的健康,初级保健专业人员(PCP)是一线护理,可以积极影响患者的行为和生活习惯。然而,相当比例的PCP不能带来健康的生活方式.因此,解决他们的健康行为可能是在一般实践中大幅增加健康促进建议的关键。地中海饮食已被广泛研究,有强有力的证据表明它是一种预防非传染性疾病的饮食模式,除了其重要的环境,社会文化,和当地经济利益。
目的:本研究仅关注PCPs生活方式的饮食方面。主要目的是评估使用电子12小时饮食召回(e-12HR)智能手机应用程序改善饮食的效果,特别是为了促进坚持地中海饮食(AMD),在PCP中。次要目标是建立e-12HR应用程序的可用性,并确定PCP中的AMD。
方法:个体水平随机,控制,单盲临床试验分为2个平行组:对照组(CG),使用e-12HR应用程序的无反馈版本,和一个干预组(IG),使用e-12HR应用程序的反馈版本。通过使用该应用程序,人类参与程度完全自动化。有28天的随访期。参与者是在选定的初级保健中心之一(安达卢西亚,西班牙,南欧),两性,18岁以上,拥有智能手机,有智能手机的读写能力。
结果:研究反应率为73%(97个PCP中的71个),27(38%)女性和44(62%)男性:CG中40(56%)PCP和IG中31(44%)。在基线,AMD是中等(平均地中海饮食评分[MDSS]指数9.45,范围0-24),47个(66%)PCP中/高MDSS指数。有显著的统计学改善(CGvsIG,支持IG)在第4周(基线无统计学差异):MDSS指数为25.6%(P=.002),中/高MDSS指数为213.1%(P=.001)。关于特定的食物类别,水果有显著的统计改善(+33.8%,P=.02),蔬菜(+352%,P=.001),坚果(+184%,P=.02),和豆类(+75.1%,P=.03)。对可用性评级问卷的回答令人满意。
结论:结果支持建议使用e-12HR应用程序作为一种工具,有助于改善PCP中的饮食和预防非传染性疾病,同时积极影响患者的饮食行为并预防患者与饮食相关的非传染性疾病。
背景:ClinicalTrials.govNCT05532137;https://clinicaltrials.gov/study/NCT05532137。
BACKGROUND: The World Health Organization has called for addressing the growing burden of noncommunicable diseases (NCDs) by promoting healthy lifestyles among the population. Regarding patient health, primary care professionals (PCPs) are the first line of care who can positively influence patients\' behavior and lifestyle habits. However, a significant percentage of PCPs do not lead a healthy lifestyle. Therefore, addressing their health behaviors may be the key to substantially increasing health promotion advice in general practice. The Mediterranean diet has been extensively studied, and there is strong evidence of it being a dietary pattern for the prevention of NCDs, in addition to its significant environmental, sociocultural, and local economics benefits.
OBJECTIVE: This study focused only on the dietary aspect of the PCPs\' lifestyle. The primary objective was to evaluate the effect of using the Electronic 12-Hour Dietary Recall (e-12HR) smartphone app to improve diet, specifically to promote adherence to the Mediterranean diet (AMD), among PCPs. The secondary objectives were to establish the usability of the e-12HR app and to determine AMD among PCPs.
METHODS: An individual-level randomized, controlled, and single-blind clinical trial was conducted with 2 parallel groups: a control group (CG), using the nonfeedback version of the e-12HR app, and an intervention group (IG), using the feedback version of the e-12HR app. The level of human involvement was fully automated through the use of the app. There was a 28-day follow-up period. Participants were PCPs (medicine or nursing) recruited offline at one of the selected primary care centers (Andalusia, Spain, Southern Europe), of both sexes, over 18 years old, possessing a smartphone, and having smartphone literacy.
RESULTS: The study response rate was 73% (71 of 97 PCPs), with 27 (38%) women and 44 (62%) men: 40 (56%) PCPs in the CG and 31 (44%) in the IG. At baseline, AMD was medium (mean Mediterranean Diet Serving Score [MDSS] index 9.45, range 0-24), with 47 (66%) PCPs with a medium/high MDSS index. There were significant statistical improvements (CG vs IG, in favor of the IG) at week 4 (no significant statistical differences at baseline): +25.6% for the MDSS index (P=.002) and +213.1% for the percentage with a medium/high MDSS index (P=.001). In relation to specific food groups, there were significant statistical improvements for fruits (+33.8%, P=.02), vegetables (+352%, P=.001), nuts (+184%, P=.02), and legumes (+75.1%, P=.03). The responses to the usability rating questionnaire were satisfactory.
CONCLUSIONS: The results support recommending the use of the e-12HR app as a tool to contribute to improving diet and preventing NCDs among PCPs, while positively influencing patient dietary behavior and preventing diet-related NCDs among patients.
BACKGROUND: ClinicalTrials.gov NCT05532137; https://clinicaltrials.gov/study/NCT05532137.