为服务不足人群提供糖尿病自我护理支持：一项使用医疗助理教练的随机试点研究。
Supporting diabetes self-care in underserved populations: a randomized pilot study using medical assistant coaches.
机构信息
The University of Illinois at Chicago, School of Public Health, Chicago, Illinois (Dr Ruggiero, Ms Moadsiri)
Mount Sinai Medical Center, Chicago, Illinois (Dr Butler)
出版信息
Diabetes Educ. 2010 Jan-Feb;36(1):127-31. doi: 10.1177/0145721709355487.
PURPOSE
The purpose of this study was to evaluate the impact of an innovative intervention that utilized a certified medical assistant with specific diabetes training to work with a multidisciplinary diabetes care team to help provide basic diabetes education and self-care support in low-income minority populations with type 2 diabetes.
METHODS
Enrolled participants were randomized to either the medical assistant coaching (MAC) group (N = 25) or the treatment as usual (TAU) group (N = 25). Deidentified data was obtained on a matched no contact control (NCC) group (N = 50).
RESULTS
Analysis of covariance (ANCOVA) comparisons revealed no significant differences between the 3 groups on A1C, but a trend was observed. A1Cs decreased across time for the MAC group, while increasing for the TAU and NCC groups. ANCOVA comparisons also indicated that the MAC group experienced significantly greater increases in perceived empowerment and a larger, although nonsignificant, reduction in perceived diabetes related problems than the TAU group.
CONCLUSIONS
This randomized controlled pilot study suggests that the inclusion of a medical assistant self-care coach as part of the diabetes care team holds promise in improving outcomes and should be further examined in a large-scale study.
目的
本研究旨在评估一项创新干预措施的影响，该措施利用经过糖尿病专业培训的认证医疗助理与多学科糖尿病护理团队合作，为 2 型糖尿病的低收入少数民族群体提供基本的糖尿病教育和自我护理支持。
方法
入组参与者被随机分配到医疗助理指导组（MAC 组，N=25）或常规治疗组（TAU 组，N=25）。在无接触对照组（NCC 组，N=50）中获得了匿名数据。
结果
协方差分析（ANCOVA）比较显示，3 组在 A1C 方面没有显著差异，但存在趋势。MAC 组的 A1C 随时间下降，而 TAU 和 NCC 组的 A1C 上升。ANCOVA 比较还表明，MAC 组在感知授权方面的显著增加，以及在感知与糖尿病相关的问题方面的显著减少（尽管无统计学意义），均显著大于 TAU 组。
结论
这项随机对照试点研究表明，将自我护理教练作为糖尿病护理团队的一部分纳入其中，有望改善治疗结果，应在大规模研究中进一步探讨。
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