Lifestyle Matters Study, 2011-2015

Background: Healthy, active ageing is strongly associated with good mental wellbeing which in turn helps to prevent mental illness. However, more investment has been made into research into interventions to prevent mental illness than into those designed to improve mental wellbeing. This applied research programme provided high quality evidence for an intervention designed to improve and sustain mental wellbeing in older adults. <br> <br> Methods/Design: This study was a multi-centre, pragmatic, two-arm, parallel group, individually randomised controlled trial to determine the population benefit of an occupational therapy based intervention for community living people aged 65 years or older. Participants (n = 268) were identified in one city in the North of England and in North Wales through GP mail-outs, signposting by local authority, primary care staff and voluntary sector organisations and through community engagement. Participants were randomised to one of two treatment arms: an intervention (Lifestyle Matters programme); or control (routine access to health and social care). All participants were assessed at baseline, 6 and 24 months post-randomisation. The primary outcome was the SF-36 Mental Health dimension at six months post randomisation. Secondary outcome measures were selected to measure psychosocial, physical and mental health outcomes. They included other dimensions of the SF36, EQ-5D-3L, Brief Resilience Scale, General Perceived Self Efficacy Scale, PHQ-9, de Jong Gierveld Loneliness Scale, Health and Social Care Resource Use and the wellbeing question of the Integrated Household Survey 2011. A cost effectiveness analysis investigated the incremental cost per Quality Adjusted Life Years (QALYs) of the Lifestyle Matters intervention compared with treatment as usual.<br> <br> Further information can be found on the Sheffield University <a href="https://www.sheffield.ac.uk/scharr/sections/dts/ctru/lifestyle_matters" title="Lifestyle Matters">Lifestyle Matters</a> webpage.<br> <br> <br>

研究背景：健康积极老龄化与良好心理健康福祉密切相关，而后者又有助于预防精神疾患。然而，相较于旨在提升心理健康福祉的干预措施，针对预防精神疾患的干预研究获得了更多的经费投入。本应用研究项目为一项旨在改善并维持老年人群心理健康福祉的干预措施提供了高质量证据。

研究方法与设计：本研究为一项多中心、实用型、双臂平行分组个体随机对照试验，旨在评估基于作业治疗的干预措施对65岁及以上社区居住人群的人群健康获益。研究共纳入268名受试者，招募范围覆盖英格兰北部一座城市及北威尔士地区，招募渠道包括全科医生（General Practitioner，GP）邮寄招募、地方政府部门、基层医疗人员及志愿机构的转介指引，以及社区动员。受试者被随机分配至两个干预组之一：干预组（「生活方式干预计划（Lifestyle Matters）」）或对照组（常规健康与社会照护服务）。所有受试者均在基线、随机分组后6个月及24个月时接受评估。主要结局指标为随机分组后6个月时的SF-36心理健康维度得分。次要结局指标用于评估社会心理、躯体及心理健康结局，涵盖SF-36其余维度、EQ-5D-3L量表、简易韧性量表（Brief Resilience Scale）、一般自我效能感量表（General Perceived Self Efficacy Scale）、PHQ-9患者健康问卷、德容-吉尔维尔德孤独量表（de Jong Gierveld Loneliness Scale）、健康与社会照护资源使用情况，以及2011年综合家庭调查（Integrated Household Survey 2011）中的福祉相关问题。本研究通过成本效用分析，评估相较于常规治疗，「Lifestyle Matters」干预措施每质量调整生命年（Quality Adjusted Life Years，QALYs）的增量成本。

更多相关信息可查阅谢菲尔德大学（Sheffield University）「Lifestyle Matters」专题网页：https://www.sheffield.ac.uk/scharr/sections/dts/ctru/lifestyle_matters