Yale Prevention Research Center, Yale University School of Medicine, Derby, CT, USA.
Health Educ Res. 2010 Apr;25(2):306-15. doi: 10.1093/her/cyp005. Epub 2009 Mar 4.
Type 2 diabetes is epidemic in the United States with greater incidence rates in African-American communities. Lifestyle interventions during the phase of insulin resistance mitigate cardiovascular risk and prevent diabetes. The primary aim of this study is to test the impact of a Community Health Advisor (CHA)-based diabetes prevention controlled intervention in urban African-American communities. In this controlled trial, church congregants in New Haven, CT, receiving a 1-year CHA-led diabetes prevention intervention were compared with church congregants in Bridgeport, CT, who did not receive an intervention. Outcome measures included physical activity, dietary pattern, anthropometric measure, social support, diabetes knowledge, nutrition and exercise self-efficacy. The results indicate that at the end of the 1-year intervention period, there were no significant differences observed between intervention and control groups. Possible explanations for the lack of change include difficulty in engaging the CHAs, variability in the CHA-led interventions, baseline discrepancies between the two sites which could not be fully controlled and loss to follow-up. The results indicate important obstacles which impeded the successful implementation of this intervention and lessons learned for future interventions.
2 型糖尿病在美国流行,非裔美国人社区的发病率更高。在胰岛素抵抗阶段进行生活方式干预可以降低心血管风险并预防糖尿病。本研究的主要目的是测试基于社区卫生顾问 (CHA) 的糖尿病预防对照干预在城市非裔美国人社区中的效果。在这项对照试验中,康涅狄格州纽黑文的教堂会众接受了为期一年的 CHA 主导的糖尿病预防干预,而康涅狄格州布里奇波特的教堂会众则没有接受干预。结果测量包括身体活动、饮食模式、人体测量指标、社会支持、糖尿病知识、营养和运动自我效能。结果表明,在为期一年的干预期结束时,干预组和对照组之间没有观察到显著差异。变化不明显的可能解释包括难以让 CHA 参与、CHA 主导的干预措施存在差异、两个地点之间的基线差异无法完全控制以及随访流失。结果表明,该干预措施的实施遇到了重要障碍,并为未来的干预措施提供了经验教训。