研究报告

米兰体育官网《石头游戏》NIHR 概要

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Macaulay L、O'Dolan C、Dombrowski S、Swingler J、Cotton S、Avenell A、Bowers D、Getaneh A、Grey CM、Hunt K、Kee F、MacLean A、Torrens C、van der Pol M 和 Hoddinott P (2025)《石头游戏》NIHR 概要。国家健康研究所。

摘要
背景肥胖男性很少接受体重管理服务。目标确定： i) 与对照组相比，有或没有经济激励的短信在 12 个月和 24 个月时的体重减轻百分比； ii) 次要结果； iii) 成本效益； iv) 有效性调节因素； iv) 参与者和利益相关者的观点。设计与方法评估者盲法随机对照试验。英国 NHS 展望 24 个月的成本效益和建模生命周期。混合方法过程评估。背景及参与者贝尔法斯特、布里斯托尔和格拉斯哥招募了 585 名体重指数≥30kg/m2 的男性（2021 年 7 月至 2022 年 5 月）；最终后续行动将于 2024 年 6 月进行。干预措施随机分配 12 个月的行为短信加上经济激励 (N=196)、仅提供相同的短信 (N=194)，或 12 个月的等待名单对照组提供 12-15 个月之间的 3 个月的短信 (N=195)。如果未达到减肥目标，将失去 400 英镑的经济奖励。主要成果指标 12 个月和 24 个月时体重变化占基线体重的百分比，将对照组与 i) 带有经济激励的文本和 ii) 仅文本进行比较。结果在 585 名男性（平均年龄 51 岁；平均体重：119 公斤）中，227 人 (39%) 生活在社会经济地位较低的地区，146 人 (25%) 报告有心理健康问题，253 人 (40%) 患有多种长期疾病。 12 个月时有 426 人（73%）完成了随访，24 个月时有 377 人（64%）完成了随访。 12 个月时，激励组、纯文本组和对照组的平均体重变化百分比 (SD) 分别为 −4.8% (6.1) [−5.7 kg]、−2.7% (6.3) [−3.0 kg] 和 −1.3% (5.5) [−1.5 kg]。与对照组相比，激励措施下的体重减轻明显更大 [−3.2%（97.5% CI，−4.6 至 −1.9；p0.001)] but not texts alone [−1.4%; CI −2.9 to 0.0; p=0.053]. At 24 months, changes were −3.9% [−4.6 kg], −2.6% [−3.1 kg], and −2.2% [−2.6 kg], no significant between-group differences. Intervention costs were £243 for texts with incentives, £110 for texts alone. There were no significant differences between 24-month costs or QALYs. Long-term modelling found texts with incentives vs. control were: QALY difference (95% CI): 0·02 (0·007, 0·029); cost difference: £176 (£43; £311); Incremental cost-effectiveness ratio (ICER): £9,748 (£7,705, £11,791). For texts alone vs. control: QALY difference: 0·03 (0·015, 0·037); cost difference: £16·5 (-£117; £152); ICER: £628 (£-5,914, £5,384) There were no moderator effects for socio-economic, health or wellbeing status for either comparison versus control. The texts with incentives group had higher engagement in weight goal setting, food changes, self-weighing, confidence, satisfaction and quality of life compared to the control. Limitations Generalisability to women, diverse ethnic groups, and people with low literacy is uncertain. Not generalisable to people with no mobile phone access. Retention was lowest in the text messages alone group. Conclusions Texts with financial incentives have a modest but important effect to12 months with clinically relevant weight loss maintenance to 24 months, are cost-effective and equally effective regardless of socioeconomic or health characteristics. Future work Implementation, adapt for women, other cultures and longer-term follow-up. Study registration: ISRCTN91974895 https://doi.org/10.1186/ISRCTN91974895 Funding: This project was funded by the National Institute for Health and Care Research Public Health Research programme (PHR 129703)

注释
其他作者：米歇尔·麦金利教授、卡特里娜·特纳教授、格雷姆·麦克伦南教授