Mohan V, Shanthirani C S, Deepa M, Datta Manjula, Williams O D, Deepa R
Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Gopalapuram, Chennai, India.
J Assoc Physicians India. 2006 Nov;54:858-62.
Randomized clinical trials have documented that lifestyle changes through physical activity can prevent diabetes. However there is no data whether such strategies are applicable at community level, that is, in a real life setting. This study demonstrates the first attempt in India, to our knowledge, of increasing physical activity through community empowerment in an attempt at primary prevention of non communicable diseases.
The Chennai Urban Population Study [CUPS] was conducted in the year 1996 in two residential areas: a middle income group the Asiad colony at Tirumangalam, and a low income group at Bharathi Nagar in T. Nagar. The Asiad colony was selected for this study. Of the 524 eligible individuals available at baseline in 1998 [age > or =20 years], 479 individuals consented for the study (response rate: 91.4%). After seven years, in 2004, the number of eligible individuals increased to 712 of whom 705 consented for the study (response rate:99%). Education regarding the benefits of physical activity was provided by mass awareness programmes like public lectures and video clippings. Both at baseline and during follow-up, details about the physical activity were collected using a validated questionnaire, which included job related and leisure time activities, and specific questions on exercise. Study individuals were then graded as having light, moderate and heavy physical activity using a scoring system.
In response to the awareness programmes given by our research team, the colony residents constructed a unique public park with their own funds. Though the occupation grades did not change, there was a significant change in the pattern of physical activity. At baseline, only 14.2% of the residents did some form of exercise. more than three times a week, which presently increased to 58.7% [p < 0.001]. The number of subjects who walked more than three times a week increased from 13.8% at baseline to 52.1% during follow-up [p < 0.001].
This study is a demonstration of how community empowerment with increased physical activity could possibly lead to prevention of diabetes and other non communicable diseases at the community level. This study also highlights the importance of sharing the results of research studies with the community.
随机临床试验已证明，通过体育活动改变生活方式可预防糖尿病。然而，尚无数据表明此类策略在社区层面，即在现实生活环境中是否适用。据我们所知，本研究是印度首次尝试通过社区赋权来增加体育活动，以初步预防非传染性疾病。
金奈城市人口研究[CUPS]于1996年在两个居民区开展：一个是位于蒂鲁芒加拉姆的中等收入群体阿西亚德殖民地，另一个是位于T.纳加尔的巴拉蒂纳加尔低收入群体。本研究选取了阿西亚德殖民地。在1998年基线时可参与研究的524名符合条件的个体（年龄≥20岁）中，有479人同意参与研究（应答率：91.4%）。七年后，即2004年，符合条件的个体数量增至712人，其中705人同意参与研究（应答率：99%）。通过公开讲座和视频剪辑等大众宣传项目，提供了有关体育活动益处的教育。在基线和随访期间，均使用经过验证的问卷收集有关体育活动的详细信息，问卷包括与工作相关和休闲时间的活动，以及有关锻炼的具体问题。然后使用评分系统将研究个体分为轻度、中度和重度体育活动等级。
为响应我们研究团队开展的宣传项目，该殖民地居民自筹资金建造了一个独特的公共公园。尽管职业等级没有变化，但体育活动模式发生了显著变化。在基线时，只有14.2%的居民每周进行三次以上某种形式的锻炼，目前这一比例增至58.7%[p<0.001]。每周步行三次以上的受试者数量从基线时的13.8%增至随访期间的52.1%[p<0.001]。
本研究表明，通过社区赋权增加体育活动可能会在社区层面预防糖尿病和其他非传染性疾病。本研究还强调了与社区分享研究结果的重要性。
