건강증진병원에서 실시된 당뇨병 및 심혈관질환 위험군 대상생활습관개선 프로그램의 질병예방 효과
Effectiveness of lifestyle interventions to prevent diabetes and cardiovascular diseases in a health promoting hospital
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Objectives: This study was conducted to expand evidence-base for the effectiveness of lifestyle intervention programs to prevent the onset of diabetes and cardiovascular diseases. Methods: Seven intervention studies between 2006 and 2014 at Korea Association of Health Promotion were analyzed. All the studies were randomized controlled trials(RCTs) and included multi-component behavioral interventions. The participants of the programs were 2,172 adults with risk factors regarding metabolic syndrome criteria. The proportions of normalized participants were compared within and across the studies using odds ratio effect sizes. Results: The reductions in the prevalence of metabolic syndrome were from 49.6% to 65.1% in intervention groups, and from 38.7% to 52.3% in comparison groups. Significant differences in effectiveness between groups were found in two studies, one in 2006 with odds ratio of 1.69(p<0.01) and another in 2009 with odds ratio of 2.36(p<0.001). Proportions of normalized participants were higher in blood pressure(31.9% to 52.5% in the intervention groups and 23.0% to 43.3% in comparison groups) than other risk factors. Abdominal obesity showed weakest improvement after the intervention in both groups. Conclusions: Lifestyle modification program is an effective method to reduce diabetes and cardiovascular risks in adults by decreasing the prevalence of metabolic syndrome and its components.
Abstract
Objectives: This study was conducted to expand evidence-base for the effectiveness of lifestyle intervention programs to prevent the onset of diabetes and cardiovascular diseases. Methods: Seven intervention studies between 2006 and 2014 at Korea Association of Health Promotion were analyzed. All the studies were randomized controlled trials(RCTs) and included multi-component behavioral interventions. The participants of the programs were 2,172 adults with risk factors regarding metabolic syndrome criteria. The proportions of normalized participants were compared within and across the studies using odds ratio effect sizes. Results: The reductions in the prevalence of metabolic syndrome were from 49.6% to 65.1% in intervention groups, and from 38.7% to 52.3% in comparison groups. Significant differences in effectiveness between groups were found in two studies, one in 2006 with odds ratio of 1.69(p<0.01) and another in 2009 with odds ratio of 2.36(p<0.001). Proportions of normalized participants were higher in blood pressure(31.9% to 52.5% in the intervention groups and 23.0% to 43.3% in comparison groups) than other risk factors. Abdominal obesity showed weakest improvement after the intervention in both groups. Conclusions: Lifestyle modification program is an effective method to reduce diabetes and cardiovascular risks in adults by decreasing the prevalence of metabolic syndrome and its components.
참고문헌 (35)
- Arima, H., "Effects of prehypertension and hypertension subtype on cardiovascular disease in the Asia-Pacific Region", Hypertension, 59, pp.1118~1123 (2012)
- Bo, S., "Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial", Journal of General Internal Medicine, 22, pp.1695~1703 (2007)
- Bradley, F., "Development and evaluation of complex interventions in health services research : Case study of the Southampton heart integrated care project(SHIP). The SHIP Collaborative Group", British Medical Journal, 318, pp.711~715 (1999)
- Briss, P. A., "Developing an evidence-based guide to community preventive services—methods", American Journal of Preventive Medicine, 18(1), pp.35~43 (2000)
- Carroll, C., "A conceptual framework for implementation fidelity", Implementation Science, 2, pp.40~ (2007)
- Crutzen, R., "Differential attrition in health behaviour change trials : A systematic review and meta-analysis", Psychology and Health, 30(1), pp.122~134 (2015)
- Davis, M. J., "Predictors of attrition from behavioral medicine treatments", Annals of Behavior Medicine, 21, pp.339~349 (1999)
- Després, J. P., "Abdominal obesity and metabolic syndrome", Nature, 444(7121), pp.881~887 (2006)
- Green, J., "The role of theory in evidence-based health promotion practice", Health Education Research, 15(2), pp.125~129 (2002)
- Harris, P. M., "Attrition revisited", American Journal of Evaluation, 19, pp.293~305 (1998)
- Hasson, H., "Systematic evaluation of implementation fidelity of complex interventions in health and social care", Implementation Science, 5, pp.67~ (2010)
- "Healthy life expectancy in Koreans"[URL]
- Johnson, S. S., "Transtheoretical model-based multiple behavior intervention for weight management : Effectiveness on a population basis", Preventive Medicine, 46(3), pp.238~246 (2008)
- Determinants of health in Korea, "Jung, Y.", Korea Institute for Health and Social Affairs, ~ (2006)
- Karlson, C. W., "Attrition in randomized controlled trials for pediatric chronic conditions", Journal of Pediatric Psychology, 34(7), pp.782~793 (2009)
- 김희선, "지역사회 대상의 대사증후군 자가관리 프로그램 중재 효과- 서울특별시 대사증후군 관리 시범사업 -", 보건교육건강증진학회지, 28(2), pp.51~62 (2011), 한국보건교육건강증진학회
- Kim, S. J., "Progression rate from new-onset pre-hypertension to hypertension in Korean adults", Circulation Journal, 75, pp.135~140 (2011)
- Results from Korea National Health and Nutrition Examination Survey IV, "Korea Centers for Disease Control and Prevention", ~ (2014)
- 대한내분비학회, "비만치료지침 2010 권고안", Endocrinology and Metabolism, 25(4), pp.301~304 (2010), 대한내분비학회
- Lim, S., "Increasing prevalence of metabolic syndrome in Korea : The Korean National Health and Nutrition Examination Survey for 1998-2007", Diabetes Care, 34, pp.1323~1328 (2011)
- Marcellus, L., "Are we missing anything? Pursuing research on attrition", Canadian Journal of Nursing Research, 36, pp.82~98 (2004)
- Meigs, J. B., "Epidemiology of the metabolic syndrome", American Journal of Management Care, 8(11), pp.S283~S292 (2002)
- Mitchell, G. K., "A comparison of methodologies from two longitudinal community based randomization controlled trials of similar interventions in palliative care: What worked and what did not?", Journal of Palliative Medicine, 8, pp.1226~1235 (2005)
- National Health Insurance Service., "National Health Screening Statistical Yearbook" (2012)
- National Cholesterol Education Program, "National Heart, Lung and Blood Institute. Third of the expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adults Treatment Panel Ⅲ)", National Institute of Health, 2002
- 오정대, "건강행위실천과 대사증후군", Korean Journal of Family Medicine, 30(02), pp.120~128 (2009), 대한가정의학회
- 오의금, "대사성증후군 중재연구 논문 분석", Journal of Korean Academy of Nursing, 37(1), pp.72~80 (2007), 한국간호과학회
- 오상우, "Obesity and Metabolic Syndrome in Korea", Diabetes and Metabolism Journal, 35(6), pp.561~566 (2011), 대한당뇨병학회
- Prochaska, J. J., "Multiple health behavior change research : An introduction and overview", Preventive Medicine, 46(3), pp.181~188 (2008)
- Rossi, P. H., "Evaluation : A systematic approach" (2004), Sage Publications Inc
- Sattar, N., "Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study", Circulation, 108(4), pp.414~419 (2003)
- 서재룡, "일개 보건소 대사 증후군 관리 프로그램의 효과 분석", 농촌의학.지역보건, 36(4), pp.264~279 (2011), 한국농촌의학.지역보건학회
- "Statistics Korea"[URL]
- USDHHS., "Prevention, detection, evaluation and treatment of high blood pressur" (2003)
- "Final research plan for healthful diet and physical activity for CVD prevention:Behavioral counseling"[URL]