针对肥胖拉丁裔青少年的社区糖尿病预防项目的开发、实施及效果
Development, implementation, and effects of community-based diabetes prevention program for obese latino youth.
作者信息
Shaibi Gabriel Q, Greenwood-Ericksen Margaret B, Chapman Cecilia R, Konopken Yolanda, Ertl Janice
机构信息
College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, USA.
出版信息
J Prim Care Community Health. 2010 Oct 1;1(3):206-12. doi: 10.1177/2150131910377909.
OBJECTIVE
Obesity and type 2 diabetes have emerged as critical health issues among Latino youth. Although both conditions manifest early in life, very few diabetes prevention programs have been developed to specifically meet the needs of this population. The authors describe the development, implementation, and metabolic impact of a culturally informed, community-based diabetes prevention program for obese Latino youth.
METHODS
A lifestyle education program was developed to address the health needs of Latino youth served by a community-based medical clinic. The program consisted of group education sessions delivered to children and their families to address nutrition, physical activity, family roles and responsibilities, and self-esteem. The metabolic impact of the program was evaluated by assessing body mass index (BMI), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, glucose, and insulin.
RESULTS
On entry, the prevalence of risk factors among the 102 youth (mean BMI, 30.4 ± 4.9 kg/m(2)) was substantial (68.6% with low HDL cholesterol, 32.1% with elevated triglycerides, 9.4% with impaired fasting glucose, 39.4% with elevated total cholesterol, 43.0% with elevated LDL cholesterol, and 60.6% with hyperinsulinemia). The 50 youth who returned after the program for follow-up measurements exhibited significant health improvements, including a 3.8% reduction in BMI; 5.4% and 8.6% decreases in total and LDL cholesterol, respectively; a 9.3% increase in HDL cholesterol; and a 24.0% decrease in fasting insulin (all P values < .05).
CONCLUSIONS
These promising findings suggest that a community-based diabetes prevention program for obese Latino youth is a feasible strategy for improving health in this high-risk population. Further studies are warranted to examine whether similar programs can be implemented in diverse communities and settings.
目的
肥胖和2型糖尿病已成为拉丁裔青少年中的关键健康问题。尽管这两种情况在生命早期就会出现，但专门针对该人群需求制定的糖尿病预防项目却很少。作者描述了一个针对肥胖拉丁裔青少年的、基于社区且具有文化特色的糖尿病预防项目的开发、实施及代谢影响。
方法
制定了一项生活方式教育项目，以满足一家社区医疗诊所所服务的拉丁裔青少年的健康需求。该项目包括为儿童及其家庭举办的小组教育课程，内容涉及营养、体育活动、家庭角色与责任以及自尊。通过评估体重指数（BMI）、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、总胆固醇、甘油三酯、血糖和胰岛素来评估该项目的代谢影响。
结果
入组时，102名青少年（平均BMI为30.4±4.9kg/m²）中的危险因素患病率较高（HDL胆固醇低者占68.6%，甘油三酯升高者占32.1%，空腹血糖受损者占9.4%，总胆固醇升高者占39.4%，LDL胆固醇升高者占43.0%，高胰岛素血症者占60.6%）。项目结束后回来接受随访测量的50名青少年的健康状况有显著改善，包括BMI降低3.8%；总胆固醇和LDL胆固醇分别降低5.4%和8.6%；HDL胆固醇升高9.3%；空腹胰岛素降低24.0%（所有P值均<0.05）。
结论
这些有前景的研究结果表明，针对肥胖拉丁裔青少年的社区糖尿病预防项目是改善这一高危人群健康状况的可行策略。有必要进一步开展研究，以检验类似项目是否能在不同社区和环境中实施。
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