Glasgow R E, Toobert D J
AMC Cancer Research Center, Vashon, Washington, USA.
Med Care. 2000 Nov;38(11):1062-73. doi: 10.1097/00005650-200011000-00002.
The objective of this work was to evaluate the reach, effectiveness, adoption, and implementation of a brief behavioral dietary intervention and 2 supplemental components of diabetes self-management support: telephone follow-up calls and community resources enhancement.
This was a 2 x 2 randomized, controlled trial investigating the incremental effects of telephone follow-up and community resources enhancement with 320 adult type 2 diabetes outpatients. METHODS. Key outcomes included behavioral (dietary patterns, fat intake), physiologic (HbA1c, lipids), and quality-of-life/patient satisfaction measures and were collected at baseline and 3- and 6-month follow-up.
Despite high reach (76% patient participation), excellent adoption (all 12 primary care practices approached participated), and good implementation, there were few outcome differences among treatment conditions. There was significant improvement across conditions in most outcomes in each category at both follow-ups.
A brief, computer-assisted, dietary goal-setting intervention basic treatment condition was moderately successful in producing dietary improvements but less so in producing biologic or quality-of-life outcomes. Additions of follow-up phone calls or a community resources enhancement component did not produce incremental improvements over this basic intervention.
本研究旨在评估一项简短的行为饮食干预以及糖尿病自我管理支持的两个补充部分（电话随访和社区资源强化）的覆盖范围、有效性、采用情况和实施情况。
这是一项2×2随机对照试验，研究电话随访和社区资源强化对320名成年2型糖尿病门诊患者的增量效应。方法：主要结局包括行为（饮食模式、脂肪摄入）、生理（糖化血红蛋白、血脂）以及生活质量/患者满意度指标，并在基线、3个月和6个月随访时收集。
尽管覆盖范围广（患者参与率达76%）、采用情况良好（所有12家参与的基层医疗诊所均参与）且实施情况良好，但各治疗组之间的结局差异不大。在两次随访中，各类别中的大多数结局在所有治疗组中均有显著改善。
一项简短的、计算机辅助的饮食目标设定干预基础治疗方案在改善饮食方面取得了一定成功，但在产生生物学或生活质量结局方面效果较差。增加随访电话或社区资源强化部分相较于该基础干预并未产生增量改善。
