个性化健康干预智慧平台应用效果评价

Evaluation of the Application Effect of Personalized Health Intervention Smart Platform

目的 使用自主开发的个性化健康干预智慧平台在社区卫生服务机构中对签约家庭医生服务的慢性病及高危人群开展健康干预,分析使用效果及局限性,为该类系统的优化和使用提供参考。方法 在广州市番禺区6个社区卫生服务机构中随机征集血压、血糖、尿酸异常的慢性病患者、慢性病高危人群、超重肥胖者参与研究。共220人通过微信小程序绑定医护人员,在常规管理基础上接受家庭医生团队为期12周线上线下结合的健康干预。对个体健康指标改善值、各类食物7天日均摄入量、一周各类运动总量、健康素养水平进行干预前后比对分析。结果 经过12周干预,入组居民体质指数、腰围、收缩压、舒张压、空腹血糖、尿酸分别平均降低0.76、3.79cm、10.43mmHg、3.50mmHg、1.08mmol/L、131.01μmol/L(P<0.05);一周碳水化合物平均供能占比、蛋白质供能占比中位数分别下降3.13%、1.28%,脂肪平均供能占比上升5.01%(P<0.01);蔬菜、水果、奶制品7天日均摄入量中位数分别增加150.0克、72.5克、100.0克,米面/杂豆、肉类、蛋、盐7天日均摄入量中位数分别减少66.0克、105.7克、5.0克、1.0克(P<0.01);一周中等强度有氧运动时间、柔韧拉伸运动天数、抗阻运动天数分别增加260.0分钟、4.0天、5.0天(P<0.01);总健康素养平均得分提升20.20%,基本知识和理念、健康生活方式与行为、健康技能平均得分分别提升16.17%、19.84%、29.55%(P<0.01)。结论 家庭医生应用个性化健康干预智慧平台对慢性病患者及高危人群进行饮食与运动干预效果良好。家庭医生团队的参与能提高居民接受健康管理的依从性,该系统具有在社区卫生服务机构中推广应用的价值。

Objective To carry out health intervention for chronic diseases and high-risk groups served by contracted family doctors in community health service institutions using the self-developed personalized health intervention smart platform,analyze the platform,s effectiveness and limitations of use,and provide references for the improvement and use of this type of system.Methods Chronic disease patients with abnormal blood pressure,blood glucose and uric acid,and high-risk groups for chronic diseases,overweight and obesity were randomly recruited from six community health service institutions in Panyu District,Guangzhou City,China,to participate in the study.A total of 220 people were bound to a healthcare provider through a WeChat app,and received a 12-week combination of online and offline health intervention by a family doctor team on the basis of routine management.Comparative analysis was conducted on improvement values of individual health indicators,7-day daily average intake of various foods,total amount of various sports per week,and health literacy level before and after intervention.Results After 12 weeks of intervention,the body mass index,waist circumference,systolic blood pressure,diastolic blood pressure,fasting blood glucose,and uric acid of the enrolled residents decreased by an average of 0.76,3.79 cm,10.43 mmHg,3.50 mmHg,1.08 mmol/L,and 131.01μmol/L respectively(P<0.05);The median proportion of carbohydrate and protein energy supply per week decreased by 3.13%and 1.28%respectively,while the average proportion of fat energy supply increased by 5.01%(P<0.01);The 7-day daily average intake of vegetables,fruits,and dairy products increased by 150.0 and 72.5,and 100.0 grams respectively;the average daily intake of rice,flour,mixed beans,meat,eggs,and salt decreased by 66.0,105.7,5.0,and 1.0 grams(P<0.01)respectively;one-week moderate-intensity aerobic exercise time,number of days of flexibility and stretching exercise,and number of days of resistance exercise increased by 260.0 min,4.0 days,and 5.0 days respectively(P<0.001);the average score of total health literacy increased by 20.20%,and the average scores of basic knowledge and concepts,healthy lifestyles and behaviors,and health skills increased by 16.17%,19.84%,and 29.55%(P<0.01).Conclusion The application of personalized health intervention smart platform by family doctors is effective in providing diet and exercise interventions for chronic disease patients and high-risk groups.The participation of family doctor team can improve the compliance of residents to health management,and there is value in promoting and applying the personalized health intervention smart platform in community health service institutions.