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“糖尿病干预与行为改变(diaBEAT-it!)”的设计与方法:一项使用RE-AIM框架的混合偏好/随机对照试验设计

Design and methods of "diaBEAT-it!": a hybrid preference/randomized control trial design using the RE-AIM framework.

作者信息

Almeida Fabio A, Pardo Kimberlee A, Seidel Richard W, Davy Brenda M, You Wen, Wall Sarah S, Smith Erin, Greenawald Mark H, Estabrooks Paul A

机构信息

Fralin Translational Obesity Research Center, Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA 24061, United States.

Department of Psychiatry, Carilion Clinic, Roanoke, VA 24014, United States.

出版信息

Contemp Clin Trials. 2014 Jul;38(2):383-96. doi: 10.1016/j.cct.2014.06.010. Epub 2014 Jun 21.

Abstract

BACKGROUND

Diabetes prevention is a public health priority that is dependent upon the reach, effectiveness, and cost of intervention strategies. However, understanding each of these outcomes within the context of randomized controlled trials is problematic.

PURPOSE

To describe the methods and design of a hybrid preference/randomized control trial using the RE-AIM framework.

METHODS

The trial, which was developed using the RE-AIM framework, will contrast the effects of 3 interventions: (1) a standard care, small group, diabetes prevention education class (SG), (2) the small group intervention plus 12 months of interactive voice response telephone follow-up (SG-IVR), and (3) a DVD version of the small group intervention with the same IVR follow-up (DVD-IVR). Each intervention includes personal action planning with a focus on key elements of the lifestyle intervention from the Diabetes Prevention Program (DPP). Adult patients at risk for diabetes will be randomly assigned to either choice or RCT. Those assigned to choice (n=240) will have the opportunity to choose between SG-IVR and DVD-IVR. Those assigned to RCT group (n=360) will be randomly assigned to SG, SG-IVR, or DVD-IRV. Assessment of primary (weight loss, reach, & cost) and secondary (physical activity, & dietary intake) outcomes will occur at baseline, 6, 12, and 18 months.

CONCLUSION

This will be the first diabetes prevention trial that will allow the research team to determine the relationships between reach, effectiveness, and cost of different interventions.

摘要

背景

糖尿病预防是一项公共卫生重点工作,它取决于干预策略的覆盖范围、有效性和成本。然而,在随机对照试验的背景下理解这些结果中的每一个都存在问题。

目的

使用RE-AIM框架描述一项混合偏好/随机对照试验的方法和设计。

方法

该试验采用RE-AIM框架开发,将对比3种干预措施的效果:(1)标准护理、小组糖尿病预防教育课程(SG),(2)小组干预加12个月交互式语音应答电话随访(SG-IVR),以及(3)具有相同IVR随访的小组干预DVD版本(DVD-IVR)。每种干预措施都包括个人行动计划,重点关注糖尿病预防计划(DPP)中生活方式干预的关键要素。有糖尿病风险的成年患者将被随机分配到选择组或随机对照试验组。分配到选择组(n = 240)的患者将有机会在SG-IVR和DVD-IVR之间进行选择。分配到随机对照试验组(n = 360)的患者将被随机分配到SG、SG-IVR或DVD-IVR组。将在基线、6个月、12个月和18个月时评估主要结局(体重减轻、覆盖范围和成本)和次要结局(身体活动和饮食摄入量)。

结论

这将是第一项能够让研究团队确定不同干预措施的覆盖范围、有效性和成本之间关系的糖尿病预防试验。

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