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The challenge of sustainability: Long-term results from the Fifty-Fifty peer group-based intervention in cardiovascular risk factors.
American Heart Journal ( IF 3.7 ) Pub Date : 2021-06-18 , DOI: 10.1016/j.ahj.2021.06.006
Juan Miguel Fernández-Alvira 1 , Rodrigo Fernández-Jiménez 2 , Mercedes de Miguel 3 , Gloria Santos-Beneit 4 , Patricia Bodega 3 , Christopher A Hill 5 , Vanesa Carral 6 , Carla Rodríguez 6 , Isabel Carvajal 6 , Xavier Orrit 6 , Amaya de Cos-Gandoy 3 , Marian Dal Re 7 , Teresa Robledo 7 , Valentín Fuster 4
Affiliation  

BACKGROUND The Fifty-Fifty trial demonstrated that a peer-group-based intervention was able to improve healthy behaviors in individuals with cardiovascular (CV) risk factors immediately post-intervention. OBJECTIVES To determine the long-term sustainability of a one-year peer-group-based intervention focused on CV health and behavior. METHODS A total of 543 adults aged 25 to 50 years with at least 1 CV risk factor were screened and recruited, received initial training through workshops, and were then randomized 1:1 to a peer-group-based intervention group (IG) or a self-management control group (CG) for 12 months. At a median of 52 months from baseline, 321 participants were re-assessed (~60% retention). The primary outcome was the mean change in a composite health score related to blood pressure, exercise, weight, alimentation, and tobacco use (Fuster-BEWAT score [FBS], range 0-15). Intervention effects were assessed using linear-mixed effects models. RESULTS The mean age of retained participants was 48.0 years (SD: 5.4), and 73% were female. Consistent with previous results, the change of overall FBS was significantly greater in the IG than in the CG at 12-month follow-up (between-group difference, 0.60 points; 95% CI, 0.08-1.12; P = .025). Assessment of long-term sustainability (52-month follow-up) showed that there were no between-group differences in the mean overall FBS (IG mean score, 8.52; 95% CI, 7.97-9.07 vs CG mean score, 8.51; 95% CI, 7.93-9.10; P = .972) or in the change of overall FBS from screening (IG mean change, 0.64; 95% CI, 0.00-1.28; CG mean change, 0.46; 95% CI, -0.20-1.12; P = .497). CONCLUSIONS A one-year peer-group-based intervention showed favorable results at immediate post-intervention but did not demonstrate significant differences between the IG and CG at 52 months. Combination of an initial training period (workshops) with the maintenance of peer-support groups or other re-intervention strategies may be required to achieve sustained effects on healthy behaviors. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02367963. Registered (https://clinicaltrials.gov/show/NCT02367963).

中文翻译:

可持续性的挑战:基于 50-50 同龄组的心血管危险因素干预的长期结果。

背景 50-50 试验表明,基于同龄人的干预能够在干预后立即改善具有心血管 (CV) 危险因素的个体的健康行为。目标 确定以 CV 健康和行为为重点的、基于同龄人群体的为期一年的干预措施的长期可持续性。方法 共有 543 名年龄在 25 至 50 岁且至少具有 1 个心血管危险因素的成年人被筛选和招募,通过研讨会接受初步培训,然后按 1:1 随机分配到基于同龄人组的干预组 (IG) 或自我管理控制组 (CG) 12 个月。在距基线平均 52 个月时,重新评估了 321 名参与者(保留率约为 60%)。主要结果是与血压、运动、体重、营养、和烟草使用(Fuster-BEWAT 评分 [FBS],范围 0-15)。使用线性混合效应模型评估干预效果。结果 保留参与者的平均年龄为 48.0 岁(SD:5.4),73% 为女性。与之前的结果一致,在 12 个月的随访中,IG 中整体 FBS 的变化显着大于 CG(组间差异,0.60 分;95% CI,0.08-1.12;P = .025)。长期可持续性评估(52 个月随访)表明,平均总体 FBS 没有组间差异(IG 平均得分,8.52;95% CI,7.97-9.07 与 CG 平均得分,8.51;95 % CI,7.93-9.10;P = .972)或筛选后整体 FBS 的变化(IG 平均变化,0.64;95% CI,0.00-1.28;CG 平均变化,0.46;95% CI,-0.20-1.12 ; P = .497)。结论 为期一年的基于同龄人组的干预在干预后立即显示出良好的结果,但在 52 个月时未显示 IG 和 CG 之间的显着差异。可能需要将初始培训期(研讨会)与同伴支持小组的维护或其他再干预策略相结合,以实现对健康行为的持续影响。试验注册 ClinicalTrials.gov 标识符 NCT02367963。注册 (https://clinicaltrials.gov/show/NCT02367963)。试验注册 ClinicalTrials.gov 标识符 NCT02367963。注册 (https://clinicaltrials.gov/show/NCT02367963)。试验注册 ClinicalTrials.gov 标识符 NCT02367963。注册 (https://clinicaltrials.gov/show/NCT02367963)。
更新日期:2021-06-17
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