Gucciardi Enza, Demelo Margaret, Lee Ruth N, Grace Sherry L
School of Nutrition, Ryerson University, Victoria St, Toronto, Ontario, Canada.
Ethn Health. 2007 Apr;12(2):163-87. doi: 10.1080/13557850601002148.
To examine the impact of two culturally competent diabetes education methods, individual counselling and individual counselling in conjunction with group education, on nutrition adherence and glycemic control in Portuguese Canadian adults with type 2 diabetes over a three-month period.
The Diabetes Education Centre is located in the urban multicultural city of Toronto, Ontario, Canada. We used a three-month randomized controlled trial design. Eligible Portuguese-speaking adults with type 2 diabetes were randomly assigned to receive either diabetes education counselling only (control group) or counselling in conjunction with group education (intervention group). Of the 61 patients who completed the study, 36 were in the counselling only and 25 in the counselling with group education intervention. We used a per-protocol analysis to examine the efficacy of the two educational approaches on nutrition adherence and glycemic control; paired t-tests to compare results within groups and analysis of covariance (ACOVA) to compare outcomes between groups adjusting for baseline measures. The Theory of Planned Behaviour was used to describe the behavioural mechanisms that influenced nutrition adherence.
Attitudes, subjective norms, perceived behaviour control, and intentions towards nutrition adherence, self-reported nutrition adherence and glycemic control significantly improved in both groups, over the three-month study period. Yet, those receiving individual counselling with group education showed greater improvement in all measures with the exception of glycemic control, where no significant difference was found between the two groups at three months.
Our study findings provide preliminary evidence that culturally competent group education in conjunction with individual counselling may be more efficacious in shaping eating behaviours than individual counselling alone for Canadian Portuguese adults with type 2 diabetes. However, larger longitudinal studies are needed to determine the most efficacious education method to sustain long-term nutrition adherence and glycemic control.
研究两种具有文化适应性的糖尿病教育方法，即个体咨询以及个体咨询与团体教育相结合的方法，对患有2型糖尿病的加拿大葡萄牙裔成年人在三个月期间营养依从性和血糖控制的影响。
糖尿病教育中心位于加拿大安大略省多元文化的城市多伦多。我们采用了为期三个月的随机对照试验设计。符合条件的讲葡萄牙语的2型糖尿病成年人被随机分配接受仅糖尿病教育咨询（对照组）或咨询与团体教育相结合（干预组）。在完成研究的61名患者中，36名仅接受咨询，25名接受咨询与团体教育干预。我们采用符合方案分析来检验两种教育方法对营养依从性和血糖控制的疗效；采用配对t检验比较组内结果，采用协方差分析（ACOVA）比较调整基线测量后的组间结果。计划行为理论用于描述影响营养依从性的行为机制。
在为期三个月的研究期间，两组的态度、主观规范、感知行为控制以及营养依从性意图、自我报告的营养依从性和血糖控制均有显著改善。然而，接受个体咨询与团体教育的患者在所有测量指标上的改善更大，但血糖控制除外，在三个月时两组之间未发现显著差异。
我们的研究结果提供了初步证据，表明对于患有2型糖尿病的加拿大葡萄牙裔成年人，具有文化适应性的团体教育与个体咨询相结合在塑造饮食行为方面可能比单独的个体咨询更有效。然而，需要更大规模的纵向研究来确定维持长期营养依从性和血糖控制的最有效教育方法。
