Impact of Lifestyle Modification on the Development of Dementia, Chronic Kidney Disease, Diabetes, Chronic Obstructive Pulmonary Disease, Cancers and Cardiovascular Disease in a Thai General Population
Impact of Lifestyle Modification on Prevention of Dementia, Chronic Kidney Disease, Diabetes, Chronic Obstructive Pulmonary Disease, Cancers and Cardiovascular Disease in a Thai General Population: Cluster Randomized Controlled Trial
調査の概要
詳細な説明
This is a community-based cluster randomized control trial aimed to investigate the impact of lifestyle modification (diet, physical activity, alcohol drinking and smoking) on the development of dementia, diabetes, chronic kidney disease, cancers, chronic obstructive pulmonary disease and cardiovascular disease in an intermediate risk population in mixed urban-rural areas of Ubon Ratchathani.
Objectives:
- examine the impact of lifestyle modification on the development of dementia, diabetes, chronic kidney disease, cancers, chronic obstructive pulmonary disease and cardiovascular disease in an intermediate risk population in Ubon Ratchathani
- examine the economic impact of lifestyle modification on prevention of dementia, diabetes, chronic kidney disease, cancers, chronic obstructive pulmonary disease and cardiovascular disease in an intermediate risk population in Ubon Ratchathani
Study design: community-based cluster randomized control trial
Setting: 60 villages randomly selected from mixed urban-rural areas in 15 districts of Ubon Ratchathani province.
Study population: 3,600 apparently healthy men and women aged 45-75 years who have resided in the village selected for at least one year. 4,000 men and women will be approached and screened.
Screening and baseline assessment:
After community consent, potential participants will be informed about the details of the project. For those who are willing to participate, written informed consent will be given before carrying out all research procedures. Participants will be questioned about their demographic characteristics, medical and family history, health behaviours including diet, physical activity, alcohol drinking and smoking. Physical activity will be assess using the Global Physical Activity Questionnaire (GPAQ) and diet will be assessed using 24 hour food recall. Their cognitive function will be assessed using the Mini-Mental State Exam (MMSE), Thai version, and clock drawing test and depression test will also be performed. Physical examination includes weight, height, blood pressure, waist and hip circumference as well as physical fitness test.
Fasting blood samples will be collected for the following laboratory tests: Complete blood count, creatinine, estimated glomerular filtration rate (eGFR), fasting plasma glucose, glycated haemoglobin (HbA1c), total cholesterol, triglyceride, HDL and estimated LDL-cholesterol, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), thyroid stimulating hormone (TSH), Ca++, PO4-, urine creatinine/albumin, urine sodium & potassium.
Interventions:
Participants in 30 villages in the intervention group will be given 4x4 lifestyle modification intervention, which will address four health behaviors (diet, physical activity, alcohol drinking and smoking) at four different levels: individual, household, knowledge management and community levels. A new computer program called 'iActive' will be used. The program was adapted from the GPAQ with add-on functions to allow real-time assessment and presentation of the energy expenditure along with recommendations specific to each individual. Dietary counseling will be given individually following assessment using a new dietary assessment program called Dietary Assessment Scanning Calculator (DISC). Home visit will be done every 3 months by responsible nurses and village health volunteers in order to assess and give simple counseling about health behaviors. Knowledge management will be undertaken through meetings and forums between participants and villages with support from trained nurses. Situation analysis and agreed community action will be encouraged to address community problems concerning four health behaviors. A combination of these intensive interventions will be given for 3 years.
Follow-up and outcome ascertainment:
Participants will be followed at 1, 2, 5 and 10 years after baseline assessment for the development of the outcomes of interest. In each follow-up, procedures identical to baseline assessment will be done.
Primary outcome: Incident dementia Incident dementia will be ascertained by a battery of screening test (MMSE, clock drawing and depression tests) and those with abnormal test results will be referred to neuro-medicine specialists at the regional hospital for further investigations and diagnosis.
Secondary outcomes:
- Type 2 diabetes mellitus
- chronic kidney disease
- cancers
- chronic obstructive pulmonary disease
- cardiovascular disease
- body mass index
- waist circumference
- blood pressure
- Fasting plasma glucose
- HbA1c
- Lipids (total cholesterol, triglyceride, HDL and estimated LDL)
Tertiary outcomes:
- MMSE scores or Cognitive decline
- Alzheimer's disease
- Physical activity levels
- Dietary intake
- prevalence of current smokers
- prevalence of alcohol consumption
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究場所
-
-
Ubon Ratchathani
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Muaeng、Ubon Ratchathani、タイ、34000
- Sanpasitthiprasong Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Thai nationality
- Age 45-75 years
- Have resided in the Ubon Ratchathani's villages for at least 1 year
- Those giving written informed consent to participate in the research project
Exclusion Criteria:
- Known case of dementia, chronic kidney disease, diabetes, chronic obstructive pulmonary disease, cancers and cardiovascular disease
- Unable to communicate well in Thai
- Unable to move or get physical exercise
- Those at risk of having complications from performing physical exercise
- Those diagnosed with cancers of any system/ organ or those in the end of life period
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:Lifestyle modification
4 x 4 lifestyle modification intervention, addressing four health behaviors including physical activity, diet, smoking and alcohol drinking, at four different levels, i.e. individual, household, group/ knowledge management, and community levels
|
Participants in the intervention group will be given 4x4 lifestyle modification intervention, which will address four health behaviors (diet, physical activity, alcohol drinking and smoking) at four different levels: individual, household, knowledge management and community levels.
A new computer program called 'iActive' adapted from the GPAQ with add-on functions to allow real-time assessment and presentation of the energy expenditure along with recommendations specific to each individual will be used.
Dietary counseling will be given individually following assessment using a new dietary assessment program called Dietary Assessment Scanning Calculator.
Home visit will be done every 3 months by responsible nurses and village health volunteers.
Knowledge management will be done through meetings between participants and villages with support from trained nurses.
Situation analysis and community action will be encouraged to address four health behaviors.
|
介入なし:Control
No special intervention will be given.
Prevention and treatment in normal practice is allowed
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Dementia
時間枠:10 years
|
Number of participants with dementia.
Incident dementia will be diagnosed by medical specialists (Neuro-Med) following a battery of screening tests, including mini-mental state exam, depression and clock drawing tests.
|
10 years
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Type 2 diabetes mellitus
時間枠:3, 5 and 10 years
|
Number of participants with type 2 diabetes mellitus.
Diabetes mellitus is biochemically and clinically diagnosed.
|
3, 5 and 10 years
|
Cardiovascular disease
時間枠:5 and 10 years
|
Number of participants with cardiovascular disease.
Clinical diagnosis of cardiovascular disease.
Diagnostic information will be obtained from medical records review and service reimbursement data.
|
5 and 10 years
|
Cancers
時間枠:5 and 10 years
|
Number of participants with cancers.
Diagnostic information will be obtained from medical records review and service reimbursement data.
|
5 and 10 years
|
Chronic obstructive pulmonary disease
時間枠:5 and 10 years
|
Number of participants with physician-diagnosed chronic obstructive pulmonary disease.
Diagnostic information will be obtained from medical records review and service reimbursement data.
|
5 and 10 years
|
Mortality
時間枠:5 and 10 years
|
All-cause mortality retrieved from death certificate database, which captures deaths nationwide, dates of death and related causes.
|
5 and 10 years
|
Blood sugar
時間枠:1, 2, 5 and 10 years
|
Blood sugar assessed as fasting plasma glucose and glycated hemoglobin (HbA1c)
|
1, 2, 5 and 10 years
|
Blood lipids
時間枠:1, 2, 5 and 10 years
|
Blood lipids include total, LDL- and HDL-cholesterol and triglyceride
|
1, 2, 5 and 10 years
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Physical activity levels
時間枠:1, 2, 5 and 10 years
|
Physical activity levels assessed using the global physical activity questionnaire (GPAQ)
|
1, 2, 5 and 10 years
|
Diet
時間枠:1, 2, 5 and 10 years
|
Diet assessed by 24 hour food recall
|
1, 2, 5 and 10 years
|
Prevalence of current smokers
時間枠:1, 2, 5 and 10 years
|
Percentage of current smokers in the study samples
|
1, 2, 5 and 10 years
|
Prevalence of alcohol consumption
時間枠:1, 2, 5 and 10 years
|
Percentage of those who report alcohol consumption
|
1, 2, 5 and 10 years
|
Cognitive function
時間枠:2, 5 and 10 years
|
Cognitive function assessed by MMSE score
|
2, 5 and 10 years
|
協力者と研究者
協力者
捜査官
- スタディディレクター:Prasert Boongird, MD、Dementia Association of Dementia
- 主任研究者:Parinya Chamnan, MD, PhD、Sanpasitthiprasong Hospital
- 主任研究者:Wannee Nitiyanant, MD、Siriraj Hospital
- 主任研究者:Wichai Aekplakorn, MD, PhD、Ramathibodi Hospital, Mahidol University
- 主任研究者:Chanida Pachotikarn, PhD、Thai Dietetic Society
- 主任研究者:Chaicharn Deerochanawong, MD、Rajvithi Hospital
- 主任研究者:Surasak Kantachuvesiri, MD, PhD、Ramathibodi Hospital, Mahidol University
- 主任研究者:Wallaya Jongjaroenprasert, MD、Ramathibodi Hospital, Mahidol University
- 主任研究者:Atiporn Ingsathit, MD, PhD、Ramathibodi Hospital, Mahidol University
- 主任研究者:Win Techakehakij, MD, PhD、Lampang Hospital
- 主任研究者:Phanida Krittayapoositpot, MD、Dementia Association of Thailand
- 主任研究者:Worawan Chailimpamontri, MD、Bhumibol Adulyadej Hospital
- 主任研究者:Ampika Mangklabruks, MD、Faculty of medicine, Chiangmai University
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- CMR-571
- HSRI 59-069 (その他の助成金/資金番号:Health System Research Institute)
- TCTR20161116001 (レジストリ識別子:Thai Clinical Trials Registry)
- 59-00-0228 (その他の助成金/資金番号:Thai Health Promotion Foundation)
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
4 x 4 lifestyle modificationの臨床試験
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Ananda Basu, MDNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); DexCom, Inc.; Tandem...完了
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Women's Hospital School Of Medicine Zhejiang UniversityJiangsu Hengrui Pharmaceutical Co., Ltd.わからない
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University Hospital, Ghent完了