University of North Carolina at Chapel Hill, North Carolina (Dr Cene, Ms Haymore, Dr Lin, Dr Corbie-Smith)
Together Transforming Lives, Inc, Enfield, North Carolina (Dr Ellis, Ms Whitaker)
Diabetes Educ. 2013 Nov-Dec;39(6):776-85. doi: 10.1177/0145721713507114. Epub 2013 Oct 15.
The purpose of this study was to describe the feasibility of using a community-based participatory research (CBPR) approach to implement the Power to Prevent (P2P) diabetes prevention education curriculum in rural African American (AA) settings.
Trained community health workers facilitated the 12-session P2P curriculum across 3 community settings. Quantitative (based on the pre- and post-curriculum questionnaires and changes in blood glucose, blood pressure [BP], and weight at baseline and 6 months) and qualitative data (based on semi-structured interviews with facilitators) were collected. Indicators of feasibility included: demand, acceptability, implementation fidelity, and limited efficacy testing.
Across 3 counties, 104 AA participants were recruited; 43% completed ≥ 75% of the sessions. There was great demand for the program. Fifteen community health ambassadors (CHAs) were trained, and 4 served as curriculum facilitators. Content and structure of the intervention was acceptable to facilitators but there were challenges to implementing the program as designed. Improvements were seen in diabetes knowledge and the impact of healthy eating and physical activity on diabetes prevention, but there were no significant changes in blood glucose, BP, or weight.
While it is feasible to use a CBPR approach to recruit participants and implement the P2P curriculum in AA community settings, there are significant challenges that must be overcome.
本研究旨在描述在农村非裔美国人（AA）环境中使用基于社区的参与式研究（CBPR）方法实施预防糖尿病的 Power to Prevent（P2P）教育课程的可行性。
经过培训的社区卫生工作者在 3 个社区环境中促进了 12 节 P2P 课程。收集了定量数据（基于课程前后的问卷以及基线和 6 个月时血糖、血压和体重的变化）和定性数据（基于对促进者的半结构化访谈）。可行性指标包括：需求、可接受性、实施保真度和有限的功效测试。
在 3 个县共招募了 104 名 AA 参与者；43%的人完成了≥75%的课程。该项目需求很大。培训了 15 名社区卫生大使（CHAs），其中 4 人担任课程促进者。干预措施的内容和结构得到了促进者的认可，但在按照设计实施该方案时存在挑战。在糖尿病知识以及健康饮食和体育活动对预防糖尿病的影响方面有了明显的改善，但血糖、血压或体重没有显著变化。
虽然在 AA 社区环境中使用 CBPR 方法招募参与者和实施 P2P 课程是可行的，但仍存在必须克服的重大挑战。
