Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
권호 표지
DOI QR코드

DOI QR Code

Development and Assessment of a Non-face-to-face Obesity-Management Program During the Pandemic

팬데믹 시기 비대면 비만관리 프로그램의 개발 및 평가

  • Park, Eun Jin (Department of Public Health, Graduate School of Kyungpook National University) ;
  • Hwang, Tae-Yoon (Department of Preventive Medicine, College of Medicine, Yeungnam University) ;
  • Lee, Jung Jeung (Department of Preventive Medicine, School of Medicine, Keimyung University) ;
  • Kim, Keonyeop (Department of Preventive Medicine, School of Medicine, Kyungpook National University)
  • 박은진 (경북대학교 대학원 보건학과) ;
  • 황태윤 (영남대학교 의과대학 예방의학교실) ;
  • 이중정 (계명대학교 의과대학 예방의학교실) ;
  • 김건엽 (경북대학교 의과대학 예방의학교실)
  • Received : 2022.09.20
  • Accepted : 2022.09.24
  • Published : 2022.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study evaluated the effects of a non-face-to-face obesity management program, implemented during the pandemic. Methods: The non-face-to-face obesity management program used the Intervention mapping protocol (IMP). The program was put into effect over the course of eight weeks, from September 14 to November 13, 2020 in 48 overweight and obese adults, who applied to participate through the Daegu Citizen Health Support Center. Results: IMP was first a needs assessment was conducted; second, goal setting for behavior change was established; third, evidence-based selection of arbitration method and performance strategy was performed; fourth, program design and validation; fifth, the program was run; and sixth, the results were evaluated. The average weight after participation in the program was reduced by 1.2kg, average WC decreased by 3cm, and average BMI decreased by 0.8kg/m2 (p<0.05). The results of the health behavior survey showed a positive improvement in lifestyle factors, including average daily intake calories, fruit intake, and time spent in walking exercise before and after participation in the program. A statistically significant difference was seen (p<0.05). The satisfaction level for program process evaluation was high, at 4.57±0.63 point. Conclusion: The non-face-to-face obesity management program was useful for obesity management for adults in communities, as it enables individual counseling by experts and active participation through self-body measurement and recording without restriction by time and place. However, the program had some restrictions on participation that may relate to the age of the subject, such as skill and comfort in using a mobile app.

본 연구는 팬데믹 시기 비대면 비만관리 프로그램의 개발하여 적용한 후 그 효과를 평가하고자 하였다. 근거기반 비대면 비만관리 프로그램 개발은 Intervention Mapping Protocol (IMP)를 이용하였다. 프로그램의 운영은 대구광역시 시민건강 놀이터 온라인 채널을 통해 참여를 신청한 과체중 및 비만 성인 48명을 대상으로 2020년 9월 14일부터 11월 13일까지 8주 동안 실시하였다. 효과평가는 프로그램 전·후 자가 신체 계측 측정, 건강행태 설문 및 만족도 설문 분석을 통해 평가하였다. IMP를 통한 중재 프로그램의 개발은 IMP 6단계의 과정을 적용하였고 1단계 요구사정은 간호·영양·운동 교육자 면담을 통해 대상자 선정 기준, 프로그램 운영 방법 등을 결정하였다. 2단계 목표 설정은 비만관리를 위한 행동 변화목표 3가지를 설정하였고 3단계에서는 건강·영양·운동 영역별 근거기반으로 건강행태 변화를 위한 중재 방법 및 수행 전략을 선택하였다. 4단계 프로그램 설계는 8주 동안 대상자의 수행 과제 및 인증방법 등 구체적으로 프로그램을 설계하였고 5단계에서는 개발된 프로그램의 실행 계획을 작성하고 실제 적용하였으며 6단계에서는 적용한 프로그램의 효과를 평가하였다. 비대면 비만관리 프로그램 참여 전·후 신체 계측 값을 통한 효과 평가 결과 평균 체중은 1.2kg이 감량되었고, 허리둘레는 3cm가 감소하였으며, 체질량지수(BMI)는 0.8kg/m2 감소하였다(p<0.05). 대상자의 건강행태 설문을 통한 효과 평가 결과는 프로그램 참여 전·후 1일 평균 섭취 열량, 과일 섭취, 걷기 운동 실천 등의 생활습관이 긍정적으로 개선되었고 통계적으로 유의한 차이가 있었다(p<0.05). 프로그램 과정 평가를 위한 만족도는 4.57±0.63점으로 높게 나타났다. 본 연구 결과에 근거하여 비대면 비만관리 프로그램은 팬데믹 시기에 시간과 장소의 제약 없이 전문가의 개별상담과 자가 신체 계측 측정 및 기록을 통한 대상자의 적극적인 참여가 가능한 프로그램으로 지역사회 성인 대상 비대면 비만 관리에 유용하게 활용될 수 있을 것이다. 그러나 비대면 비만관리 프로그램은 앱 사용 등 대상자의 나이에 따라 비대면 프로그램 참여에 일부 제약이 있다. 따라서 본 연구로 개발된 비대면 프로그램과 함께 필요시 대면 프로그램의 병행을 제언하며, 추후 장기적인 프로그램의 운영에 따른 효과 평가를 검증하기 위한 지속적인 연구들이 필요할 것으로 사료된다.

Keywords

References

  1. Obesity and overweight, Fact Sheet. World Health Organization (WHO), 2017
  2. Development of an implementation roadmap 2023-2030 for the global action plan for the prevention and control of NCDs, 2013-2030. WHO, 2021
  3. World obesity atlas. World Obesity, 2022
  4. 2013-2017 Obesity fact sheet. Korea Health Promotion Institute, 2018
  5. The 5 th national health plan 2030, 2021-2030. Korea Health Promotion Institute, 2022
  6. Korea community health at a glance 2021: Korea Community Health Survey (KCHS). Korea Disease Control and Prevention Agency (KDCA), 2022
  7. Korea health Statics 2020: Korea National Health and Nutrition Examination Survey (KNHANES VIII-2). KDCA, 2022
  8. Egger G, Binns A, Rossner S. Lifestyle medicine: Managing diseases of lifestyle in the 21st century (2nd ed). North Ryde (NSW), McGraw-Hill, 2011, pp.95-168
  9. Yoon NH. Effects of health behaviors and community environments on obesity prevention and management: mixed methods with qualitative research and multilevel analysis. The Graduate School of Seoul National University, 2016 (Korean).
  10. Wadden TA, Butryn ML, Hong PS, Tsai AG. Behavioral treatment of obesity in patients encountered in primary care settings: A systematic review. JAMA 2014;312(17):1779-1791 https://doi.org/10.1001/jama.2014.14173
  11. Kok G, Lo SH, Peters GJY, Ruiter RA. Changing energy-related behavior: An intervention mapping approach. Energy Policy 2011;39(9):5280-5286 https://doi.org/10.1016/j.enpol.2011.05.036
  12. Jo HH. Development and application of integrated health promotion program based on self-determinism theory for middle-aged people. The Graduate School of Kyung Hee University, 2020 (Korean)
  13. Bartholomew Eldredge, LK, Parcel GS, Kok G, Gottlieb NH, Fernandez ME. Planning health promotion programs: An intervention mapping approach (4th ed). San Francisco, CA: Jossey-Bass, 2016, pp.209-597
  14. Quick reference guideline. Korea society for the study of obesity, 2020
  15. Hwang IJ. Development and evaluation of the program to promote obesity prevention behaviors for pre-schoolers in Korea. The Graduate School of Seoul National University, 2019 (Korean)
  16. Park JY, Cho JH, Im MH, Hwang GH. A scoping review of health-related intervention studies using intervention mapping in South Korea. J Korean Public Health Nurs 2021;35(3):448-468 (Korean)
  17. Ko JW, Kang HW. Mobile health interventions for community-dwelling patients with heart diseases: an integrative review. J Korean Crit Care Nurs 2020;13(1):63-75 (Korean) https://doi.org/10.34250/jkccn.2020.13.1.63
  18. Kim KH. Effects of weight control program on body mass index. serum lipid levels, self-regulation behavior, and body image of obese college women. The Graduate School, Kyungpook National University, 2004 (Korean)
  19. Ahn BC, Joung HJ. Socioeconomic cost of obesity in Korea. J Nutr 2005;38(9):786-792 (Korean)
  20. Hagarty MA, Schmidt C, Bernaix L, Clement JM. Adolescent obesity: current trends in identification and management. J Am Acad Nurse Pract 2004;16(11):481-489 https://doi.org/10.1111/j.1745-7599.2004.tb00427.x
  21. Park HJ, Jang IS. The effect of telephone counseling hypertension self-management program for hypertensive patients with disabilities using the welfare center for the disabled. J Korean Appl Sci & Tech 2020;37(4):659-673 (Korean)
  22. Yang SW, Moon KT, Kim JB. A case study on the application of digital healthcare device for integrated care of community in the corona. Korean Soc of Sci & Art 2021;39(4):235-242 (Korean) https://doi.org/10.17548/ksaf.2021.09.30.235
  23. Kim HK, Kim MJ. Effects of weight control program on dietary habits and blood composition in obese middle-aged women. J Nutr 2010;43(3):273-284 (Korean)
  24. 2019 Citizen health support center project report. Daegu, Korean, Daegu Citizen health support center, 2020, pp.17-18
  25. Lee HJ, Lee JJ, Hwang TY, Kam S. Development and evaluation of a community staged education program for the cardiocerebrovascular disease high-risk patients. J Agric Med Community Health 2012;37(3):167-180 (Korean) https://doi.org/10.5393/JAMCH.2012.37.3.167
  26. Kim EJ, Hwang HJ. Effects of a nutrition education and exercise program of overweight or obese female adults on nutritional and health status. J Korean Soc Food Sci Nutr 2010;39(1):78-84 (Korean) https://doi.org/10.3746/jkfn.2010.39.1.078
  27. Kim KD, Song YO, Bae YH. Effects of belly dancing and nutritional education on body composition and serum lipids profiles of obese women in a study, 'Obesity Clinic Projects at Community Health Center'. J Korean Soc Food Sci Nutr 2011;40(10): 1417-1422 (Korean) https://doi.org/10.3746/jkfn.2011.40.10.1417
  28. Park CI, Woo JJ. Effects of a primary healthcare post obesity management program for middle-aged obese women living in rural areas. J Korean Acad of Rural Health Nursing 2016;11(1):15-22 (Korean)
  29. Ha CH, Ha S, So WY. Effects of a 12-week combined exercise training program on the body composition, physical fitness levels, and metabolic syndrome profiles of obese women. J Korean Public Health Nurs 2012;26(3):417-427 (Korean) https://doi.org/10.5932/JKPHN.2012.26.3.417
  30. Kim H. Effects of community based participatory obesity intervention program in middle-aged women. J Korean Public Health Nurs 2015;29(1):79-89 (Korean) https://doi.org/10.5932/JKPHN.2015.29.1.79
  31. Chang MH, Jung SJ. Effects of nutrition education and exercise program on obesity index and behavioral modification in moderate obese women. Korean J Community Nutr 2018;23(4):318-332 (Korean) https://doi.org/10.5720/kjcn.2018.23.4.318
  32. Said MA, Abdelmoneem M, Alibrahim MC, Elsebee MA, Kotb AAH. Effects of diet versus diet plus aerobic and resistance exercise on metabolic syndrome in obese young men. J Exerc Sci Fit 2020;18(3): 101-108 https://doi.org/10.1016/j.jesf.2020.03.002
  33. Kim YS, Shin JK, Hong IS, Kim SH, Chang UJ. Weight control program through the fortification of food consumption monitoring on obese female college students: using smart-phone with real time communication application. Korean J Community Nutr 2011;16(6):697-705 (Korean) https://doi.org/10.5720/kjcn.2011.16.6.697
  34. Chang UJ, Ko SA. A study on the dietary intake survey method using a cameraphone. Korean J Community Nutr 2007;12(2):198-205 (Korean)
  35. Polivy J, Herman CP. Causes of eating disorders. Annu Rev Psychol 2002:53:187-213 https://doi.org/10.1146/annurev.psych.53.100901.135103
  36. Kang JS, Kim HS. A Study on the evaluation of a nutritional education program for the middle aged obese women. Korean J of Food & Nutr 2004;17(4):356-367 (Korean)
  37. Kang JY, Cho SW, Lee JY, Sung SH, Park YK, Paek YM, Choi TI. The effects of a worksite on-line health education program on metabolic syndrome risk factors and nutrient intakes of male workers. J Nutr 2010;43(1):57-68 (Korean)
  38. Jeon MK, Ha JY. Effects of a smart phone weight loss program on obesity and body composition in adolescents. J Korean Public Health Nurs 2013;27(1):102-112 (Korean) https://doi.org/10.5932/JKPHN.2013.27.1.102
  39. Byun SH, Kim JM. The preliminary study for the development and efficiency of a computer-based cognitive behavioral therapy program for weight management in obese women. Cogn Behav Ther in Korea 2015;15(3):541-569 (Korean)