基于网络的行为和生活方式干预的效果及可行性初步研究

目的评价基于网络的行为和生活方式干预的效果及可行性。方法681例对象随机分为干预组（n=341）和对照组（n=340）。干预组每月登录网站。研究人员通过电子邮件及聊天室等每月督促管理对象递交健康日志，提供个人健康管理计划以及由计算机自动生成的个体化的健康改善建议，并解答管理对象提出的健康相关问题。对照组接受常规医疗服务。采用意向性处理分析，比较两组干预前及第6个月时相关行为和生活方式及体检指标，并进行组间比较。结果第6个月时，干预组和对照组中吸烟者戒烟率分别为23．6％和4．6％（χ^2=22．4，P〈0．05）；两组过量饮酒者平均每日酒精摄人量分别减少28．6g和6．1g（t=14．9，P〈0．05）。两组体力活动不足者体育锻炼时间均无明显变化。干预组膳食结构改善，而对照组无显著变化。干预组中高血压病患者平均收缩压、糖尿病患者平均空腹血糖值、超重和肥胖者平均体重指数下降，且差异均有统计学意义（P〈0．05），而对照组中上述指标均无明显变化。两组高胆固醇血症患者血清总胆固醇水平均无明显变化。干预组第6个月时退出率为6．7％。结论基于网络的健康管理服务可以有效地帮助改善部分健康相关行为，并有助于高血压病、糖尿病及超重和肥胖的控制。

Effectiveness and feasibility of web-based lifestyle and behavior intervention

Objective To evaluate the effectiveness and feasibility of web-based lifestyle or behavior intervention on Chinese urban adults. Methods Six hundred and eighty-one adult subjects were randomly assigned to the intervention group （ n = 341 ） or the control group （ n = 340 ）. The intervention group was encouraged to visit a specified interactive web site at least once a month to submit self-report health diaries, and provided with individualized health promotion instructions and tailored counseling at the chat room or through email. The control group received routine medical services. The primary outcomes were changes in cigarette smoking, alcohol consumption, fruit or vegetable intake, and physical exercise duration at 6 month from baseline. Intention-to-treat method was used for data analysis. Results At 6 month, smoking cessation rate was 23. 6% in intervention group and 4. 6% in control group （χ^2 = 22. 4, P 〈 0. 05 ）, and daily alcohol consumption decreased by 28.6 g in intervention group compared to 6. 1 g in control group （ t = 14. 9 ,P 〈 0.05）. There was no significant change in physical exercise duration for those with sub-optimal physical activities between the two groups. In contrast to the control group, mean systolic blood pressure, fasting blood glucose, and body mass index of the hypertensive, diabetic, or overweight/obese subjects in the intervention group showed statistically significant decrease. There was no significant change in serum cholesterol level for the participants with hypereholesterolemia in both groups. The attrition rate was 6. 7% in the intervention group. Conclusion Web-based health management services may be helpful in promoting healthy lifestyle and behavior and enhancing the care of chronic conditions including hypertension, diabetes, overweight and obese.