Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA 94115, USA.
Am J Public Health. 2012 Aug;102(8):1551-8. doi: 10.2105/AJPH.2011.300456. Epub 2012 Jun 14.
We evaluated a community-based, translational lifestyle program to reduce diabetes risk in lower-socioeconomic status (SES) and ethnic minority adults.
Through an academic-public health department partnership, community-dwelling adults at risk for diabetes were randomly assigned to individualized lifestyle counseling delivered primarily via telephone by health department counselors or a wait-list control group. Primary outcomes (6 and 12 months) were fasting glucose level, triglycerides, high- and low-density lipoprotein cholesterol, weight, waist circumference, and systolic blood pressure. Secondary outcomes included diet, physical activity, and health-related quality of life.
Of the 230 participants, study retention was 92%. The 6-month group differences for weight and triglycerides were significant. The intervention group lost 2 pounds more than did the control group (P=.03) and had decreased triglyceride levels (difference in change, 23 mg/dL; P=.02). At 6 months, the intervention group consumed 7.7 fewer grams per day of fat (P=.05) and more fruits and vegetables (P=.02) than did control participants.
Despite challenges designing effective translational interventions for lower-SES and minority communities, this program modestly improved some diabetes risk factors. Thus, individualized, telephone-based models may be a promising alternative to group-based interventions.
我们评估了一项基于社区的、转化生活方式的项目,以降低社会经济地位较低(SES)和少数族裔成年人的糖尿病风险。
通过学术-公共卫生部门的合作,将有糖尿病风险的社区居民随机分配到个体化的生活方式咨询组,主要通过健康部门顾问的电话提供咨询,或分配到等待名单对照组。主要结局(6 个月和 12 个月)是空腹血糖水平、甘油三酯、高低密度脂蛋白胆固醇、体重、腰围和收缩压。次要结局包括饮食、身体活动和健康相关的生活质量。
在 230 名参与者中,有 92%的人保留了研究。体重和甘油三酯的 6 个月组间差异具有统计学意义。干预组比对照组多减重 2 磅(P=.03),甘油三酯水平也有所下降(变化差异,23mg/dL;P=.02)。在 6 个月时,干预组每天摄入的脂肪减少了 7.7 克(P=.05),摄入的水果和蔬菜更多(P=.02)。
尽管为 SES 较低和少数民族社区设计有效的转化干预措施存在挑战,但该项目适度改善了一些糖尿病风险因素。因此,个体化、基于电话的模式可能是小组干预的一种有前途的替代方案。