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：

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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)。