Abstract
Metabolic-associated fatty liver disease (MAFLD) is a prevalent condition associated with significant hepatic morbidity, yet evidence-based community interventions remain limited. This mixed-methods study first assessed self-management capacity and quality of life (QOL) among MAFLD patients (n = 218) in community settings, revealing suboptimal self-management (mean score 2.84 ± 0.73) and moderate QOL (3.23 ± 0.77), with education level and occupation identified as predictors. Subsequently, a randomized controlled trial (RCT) evaluated a novel community-based multidisciplinary intervention (nutritional counseling, behavioral coaching, clinical monitoring) versus standard education (n = 100). At 3-month follow-up, the intervention group demonstrated clinically significant improvements versus controls: greater weight reduction (-9.76 vs 0.11 kg; P = .028), body mass index (BMI) decrease (-3.01 vs 0.28 kg/m²; P = .006), and QOL enhancement (+8.97 vs. +2.83 points; P = .002). Significant metabolic and hepatic improvements included reduced liver steatosis (controlled attenuation parameter [CAP]: -29 dB/m; P = .001), lower liver enzymes (alanine aminotransferase [ALT]: -12 U/L, P = .039; aspartate aminotransferase [AST]: -5.5 U/L, P = .015), and decreased fasting glucose (-0.97 mmol/L; P = .026). This scalable multidisciplinary model effectively enhances self-management adherence, improves metabolic health and hepatic parameters, and boosts QOL in MAFLD, offering a resource-efficient strategy for reducing chronic disease burden in primary care.