Diabetes Care. 2002 Dec;25(12):2165-71. doi: 10.2337/diacare.25.12.2165.
The purpose of the present article is to provide a detailed description of the highly successful lifestyle intervention administered to 1,079 participants, which included 45% racial and ethnic minorities and resulted in a 58% reduction in the incidence rate of diabetes (2). The two major goals of the Diabetes Prevention Program (DPP) lifestyle intervention were a minimum of 7% weight loss/weight maintenance and a minimum of 150 min of physical activity similar in intensity to brisk walking. Both goals were hypothesized to be feasible, safe, and effective based on previous clinical trials in other countries (3-7). The methods used to achieve these lifestyle goals include the following key features: 1) individual case managers or "lifestyle coaches;" 2) frequent contact with participants; 3) a structured, state-of-the-art, 16-session core-curriculum that taught behavioral self-management strategies for weight loss and physical activity; 4) supervised physical activity sessions; 5) a more flexible maintenance intervention, combining group and individual approaches, motivational campaigns, and "restarts;" 6) individualization through a "toolbox" of adherence strategies; 7) tailoring of materials and strategies to address ethnic diversity; and finally 8) an extensive network of training, feedback, and clinical support.
本文的目的是详细描述对1079名参与者实施的极为成功的生活方式干预措施,其中45%为少数族裔,该干预使糖尿病发病率降低了58%(2)。糖尿病预防计划(DPP)生活方式干预的两个主要目标是至少减轻7%的体重/维持体重,以及至少进行150分钟与快走强度相似的体育活动。基于其他国家先前的临床试验(3 - 7),这两个目标被认为是可行、安全且有效的。实现这些生活方式目标所采用的方法包括以下关键特征:1)个人个案管理员或“生活方式教练”;2)与参与者频繁接触;3)一个结构化的、先进的、为期16节的核心课程,教授减肥和体育活动的行为自我管理策略;4)有监督的体育活动课程;5)一种更灵活的维持干预措施,结合小组和个人方法、激励活动以及“重新开始”;6)通过一系列依从性策略“工具箱”实现个性化;7)针对种族多样性调整材料和策略;最后8)建立广泛的培训、反馈和临床支持网络。