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Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial

BACKGROUND: Obesity is reaching epidemic proportions in both developed and developing countries. Even modest weight gain increases the risk for chronic illness, yet evidence-based interventions to prevent weight gain are rare. This trial will determine if a simple low-intensity intervention can prev...

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Autores principales: Lombard, Catherine, Harrison, Cheryce, Kozica, Samantha, Zoungas, Sophia, Ranasinha, Sanjeeva, Teede, Helena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718637/
https://www.ncbi.nlm.nih.gov/pubmed/26785406
http://dx.doi.org/10.1371/journal.pmed.1001941
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author Lombard, Catherine
Harrison, Cheryce
Kozica, Samantha
Zoungas, Sophia
Ranasinha, Sanjeeva
Teede, Helena
author_facet Lombard, Catherine
Harrison, Cheryce
Kozica, Samantha
Zoungas, Sophia
Ranasinha, Sanjeeva
Teede, Helena
author_sort Lombard, Catherine
collection PubMed
description BACKGROUND: Obesity is reaching epidemic proportions in both developed and developing countries. Even modest weight gain increases the risk for chronic illness, yet evidence-based interventions to prevent weight gain are rare. This trial will determine if a simple low-intensity intervention can prevent weight gain in women compared to general health information. METHODS AND FINDINGS: We conducted a 1-yr pragmatic, cluster randomised controlled trial in 41 Australian towns (clusters) randomised using a computer-generated randomisation list for intervention (n = 21) or control (n = 20). Women aged 18 to 50 yr were recruited from the general population to receive a 1-yr self-management lifestyle intervention (HeLP-her) consisting of one group session, monthly SMS text messages, one phone coaching session, and a program manual, or to a control group receiving one general women’s health education session. From October 2012 to April 2014 we studied 649 women, mean age 39.6 yr (+/− SD 6.7) and BMI of 28.8 kg/m(2) (+/− SD 6.9) with the primary outcome weight change between groups at 1 yr. The mean change in the control was +0.44 kg (95% CI −0.09 to 0.97) and in the intervention group −0.48kg (95% CI −0.99 to 0.03) with an unadjusted between group difference of −0.92 kg (95% CI −1.67 to −0.16) or −0.87 kg (95% CI −1.62 to −0.13) adjusted for baseline values and clustering. Secondary outcomes included improved diet quality and greater self-management behaviours. The intervention appeared to be equally efficacious across all age, BMI, income, and education subgroups. Loss to follow-up included 23.8% in the intervention group and 21.8% in the control group and was within the anticipated range. Limitations include lack of sensitive tools to measure the small changes to energy intake and physical activity. Those who gained weight may have been less inclined to return for 1 yr weight measures. CONCLUSIONS: A low intensity lifestyle program can prevent the persistent weight gain observed in women. Key features included community integration, nonprescriptive simple health messages, small changes to behaviour, low participant burden, self-weighing, and delivery including a mix of group, phone, and SMS text reminders. The findings support population strategies to halt the rise in obesity prevalence.
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spelling pubmed-47186372016-01-30 Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial Lombard, Catherine Harrison, Cheryce Kozica, Samantha Zoungas, Sophia Ranasinha, Sanjeeva Teede, Helena PLoS Med Research Article BACKGROUND: Obesity is reaching epidemic proportions in both developed and developing countries. Even modest weight gain increases the risk for chronic illness, yet evidence-based interventions to prevent weight gain are rare. This trial will determine if a simple low-intensity intervention can prevent weight gain in women compared to general health information. METHODS AND FINDINGS: We conducted a 1-yr pragmatic, cluster randomised controlled trial in 41 Australian towns (clusters) randomised using a computer-generated randomisation list for intervention (n = 21) or control (n = 20). Women aged 18 to 50 yr were recruited from the general population to receive a 1-yr self-management lifestyle intervention (HeLP-her) consisting of one group session, monthly SMS text messages, one phone coaching session, and a program manual, or to a control group receiving one general women’s health education session. From October 2012 to April 2014 we studied 649 women, mean age 39.6 yr (+/− SD 6.7) and BMI of 28.8 kg/m(2) (+/− SD 6.9) with the primary outcome weight change between groups at 1 yr. The mean change in the control was +0.44 kg (95% CI −0.09 to 0.97) and in the intervention group −0.48kg (95% CI −0.99 to 0.03) with an unadjusted between group difference of −0.92 kg (95% CI −1.67 to −0.16) or −0.87 kg (95% CI −1.62 to −0.13) adjusted for baseline values and clustering. Secondary outcomes included improved diet quality and greater self-management behaviours. The intervention appeared to be equally efficacious across all age, BMI, income, and education subgroups. Loss to follow-up included 23.8% in the intervention group and 21.8% in the control group and was within the anticipated range. Limitations include lack of sensitive tools to measure the small changes to energy intake and physical activity. Those who gained weight may have been less inclined to return for 1 yr weight measures. CONCLUSIONS: A low intensity lifestyle program can prevent the persistent weight gain observed in women. Key features included community integration, nonprescriptive simple health messages, small changes to behaviour, low participant burden, self-weighing, and delivery including a mix of group, phone, and SMS text reminders. The findings support population strategies to halt the rise in obesity prevalence. Public Library of Science 2016-01-19 /pmc/articles/PMC4718637/ /pubmed/26785406 http://dx.doi.org/10.1371/journal.pmed.1001941 Text en © 2016 Lombard et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Lombard, Catherine
Harrison, Cheryce
Kozica, Samantha
Zoungas, Sophia
Ranasinha, Sanjeeva
Teede, Helena
Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial
title Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial
title_full Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial
title_fullStr Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial
title_full_unstemmed Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial
title_short Preventing Weight Gain in Women in Rural Communities: A Cluster Randomised Controlled Trial
title_sort preventing weight gain in women in rural communities: a cluster randomised controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718637/
https://www.ncbi.nlm.nih.gov/pubmed/26785406
http://dx.doi.org/10.1371/journal.pmed.1001941
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