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社交网络干预对2型糖尿病的影响:一项部分随机研究。

Effect of social networks intervention in type 2 diabetes: a partial randomised study.

作者信息

Shaya Fadia T, Chirikov Viktor V, Howard Deleonardo, Foster Clyde, Costas Julian, Snitker Soren, Frimpter Jeffrey, Kucharski Kathrin

机构信息

University of Maryland School of Pharmacy, , Baltimore, Maryland, USA.

出版信息

J Epidemiol Community Health. 2014 Apr;68(4):326-32. doi: 10.1136/jech-2013-203274. Epub 2013 Dec 2.

Abstract

BACKGROUND

In this partially randomised intervention study, we assessed the effect of social networks on the improvement of type 2 diabetes management in a largely African-American population in Baltimore.

METHODS

Patients in the intervention group (n=68) were asked to recruit peers, form small groups, and attend monthly diabetes education sessions, emphasising peer support. Patients in the control group (n=70) were recruited individually to attend standard diabetes education sessions. The primary outcomes were changes in haemoglobin A1C (HbA1c) and blood glucose. Secondary outcomes included blood pressure, weight, functional status, self-efficacy, perceived cohesion, social network connectedness and diabetes knowledge. General linear mixed models were built to assess mean absolute changes in primary and secondary outcomes at 3 and 6 months.

RESULTS

At 6 months from baseline, the social network intervention group achieved a larger reduction in HbA1c of -0.32% (p<0.0001) and blood glucose of -10.6 mg/dL, (p<0.0001) compared to the control group. In analyses of secondary endpoints, the intervention group had more favourable outcomes over time for weight, quality of life, self-efficacy, social network scores and diabetes knowledge, compared to the control group. While blood pressure decreased, and perceived cohesion increased in both groups over the duration of the study, the difference between groups was not statistically significant.

CONCLUSIONS

The social networks intervention showed improved integration of patients within their existing networks leading to a greater reduction in HbA1c and blood glucose, as well as improved behaviour mediating outcomes.

摘要

背景

在这项部分随机干预研究中,我们评估了社交网络对巴尔的摩一个主要为非裔美国人的群体改善2型糖尿病管理的效果。

方法

干预组患者(n = 68)被要求招募同龄人、组成小组并参加每月一次的糖尿病教育课程,强调同伴支持。对照组患者(n = 70)被单独招募参加标准糖尿病教育课程。主要结局指标为糖化血红蛋白(HbA1c)和血糖的变化。次要结局指标包括血压、体重、功能状态、自我效能感、感知凝聚力、社交网络连通性和糖尿病知识。建立了一般线性混合模型来评估3个月和6个月时主要和次要结局指标的平均绝对变化。

结果

与对照组相比,从基线开始6个月时,社交网络干预组的HbA1c降低幅度更大,为-0.32%(p < 0.0001),血糖降低了-10.6 mg/dL(p < 0.0001)。在次要终点分析中,与对照组相比,随着时间推移,干预组在体重、生活质量、自我效能感、社交网络得分和糖尿病知识方面有更有利的结局。虽然在研究期间两组的血压均下降,且感知凝聚力均增加,但两组之间的差异无统计学意义。

结论

社交网络干预显示患者在其现有网络中的融入得到改善,导致HbA1c和血糖降低幅度更大,以及行为介导结局得到改善。

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