Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15213, USA.
Am J Prev Med. 2009 Dec;37(6):505-11. doi: 10.1016/j.amepre.2009.07.020.
The Diabetes Prevention Program (DPP) demonstrated that lifestyle intervention reduces risk for type 2 diabetes and the metabolic syndrome. A universal framework for translation of multiple aspects of the DPP intervention, including training, support, and evaluation is needed to enhance treatment fidelity in a variety of settings.
This study aims to develop a comprehensive model for diabetes prevention translation using a modified DPP lifestyle intervention.
The DPP lifestyle intervention was adapted to a 12-session group-based program called Group Lifestyle Balance for implementation in the community setting. A model for training and support mirroring that of the DPP was developed for prevention professionals administering the program. The process of training/support and program implementation was evaluated for feasibility and effectiveness using a nonrandomized prospective design in two phases (N=51, Phase 1: 2005-2006; N=42, Phase 2: 2007-2009; data analysis completed 2008-2009). A total of 93 nondiabetic individuals with BMI >or=25 kg/m(2) and the metabolic syndrome or prediabetes participated. Measures were collected at baseline and post-intervention for all and 6 and 12 months post-intervention for Phase 2.
Significant decreases in weight, waist circumference, and BMI were noted in both phases from baseline. Participants in Phase 2 also demonstrated decreases in total cholesterol, non-HDL cholesterol, and systolic and diastolic blood pressure that were maintained at 12 months. Average combined weight loss for both groups over the course of the 3-month intervention was 7.4 pounds (3.5% relative loss, p<0.001); 23.8% and 52.2% of those who completed the program reached 7% and 5% weight loss, respectively. More than 80% of those achieving 7% weight loss in the Phase-2 group maintained their weight loss at 6 months.
A comprehensive diabetes prevention model for training, intervention delivery, and support was shown to be successful and was effective in reducing diabetes and cardiovascular disease risk factors in this group of high-risk individuals.
糖尿病预防计划（DPP）表明，生活方式干预可降低 2 型糖尿病和代谢综合征的发病风险。需要为 DPP 干预的多个方面制定通用的翻译框架，包括培训、支持和评估，以提高各种环境下的治疗一致性。
本研究旨在使用改良的 DPP 生活方式干预方法，开发一种全面的糖尿病预防翻译模型。
将 DPP 生活方式干预改编为 12 节基于小组的团体生活平衡计划，以在社区环境中实施。为实施该计划的预防专业人员制定了培训/支持模型，该模型与 DPP 的模式相匹配。使用非随机前瞻性设计在两个阶段（N=51，第 1 阶段：2005-2006 年；N=42，第 2 阶段：2007-2009 年；数据分析于 2008-2009 年完成）评估培训/支持和方案实施的可行性和有效性。共有 93 名 BMI>或=25kg/m2 且患有代谢综合征或糖尿病前期的非糖尿病个体参与了研究。所有参与者在基线和干预后进行测量，第 2 阶段的参与者在干预后 6 个月和 12 个月进行测量。
两个阶段的体重、腰围和 BMI 均从基线显著下降。第 2 阶段的参与者还显示出总胆固醇、非高密度脂蛋白胆固醇、收缩压和舒张压的降低，这些指标在 12 个月时仍保持不变。两组在 3 个月干预过程中的平均总体重减轻量为 7.4 磅（相对减轻 3.5%，p<0.001）；完成该计划的参与者中，分别有 23.8%和 52.2%的人达到了 7%和 5%的体重减轻。在第 2 阶段体重减轻 7%的人群中，超过 80%的人在 6 个月时保持了体重减轻。
本研究证明了一种全面的糖尿病预防培训、干预实施和支持模型是成功的，能够有效降低该高危人群的糖尿病和心血管疾病风险因素。
