Samuel-Hodge C D, Johnson C M, Braxton D F, Lackey M
Department of Nutrition, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA; Center for Health Promotion and Disease Prevention, University of North Carolina-Chapel Hill, NC, USA.
Obes Rev. 2014 Oct;15 Suppl 4:107-24. doi: 10.1111/obr.12211.
The Diabetes Prevention Program (DPP) demonstrated risk reduction for incident diabetes through weight loss among all participants, including African Americans. Several DPP translations have been conducted in less controlled settings, including primary care practices and communities; however, there is no detailed compilation of how effective these translations have been for African Americans. This systematic literature review evaluated DPP translations from 2003 to 2012. Eligible records were retrieved using a search strategy of relevant databases and gray literature. Retrieved records (n=1,272) were screened using a priori criteria, which resulted in 21 full-text studies for review. Seventeen studies were included in the full-text qualitative synthesis. Seven studies had 100% African American samples and 10 studies had mixed samples with African American subgroups. African American participants' average weight loss was roughly half of that achieved in the DPP intervention. However, with few higher-quality studies, small sample sizes and differences in intervention designs and implementation, comparisons across interventions were difficult. The suboptimal effectiveness of DPP translations among African American adults, particularly women, signals the need for enhancements to existing evidence-based interventions and more high-quality research that includes other at-risk African American subgroups such as men and younger adults of lower socioeconomic status.
糖尿病预防计划(DPP)表明,包括非裔美国人在内的所有参与者通过减重可降低患糖尿病的风险。在包括初级保健机构和社区等控制较差的环境中已开展了多项DPP转化研究;然而,对于这些转化研究对非裔美国人的效果如何,尚无详细的汇总情况。这项系统文献综述评估了2003年至2012年期间的DPP转化研究。通过对相关数据库和灰色文献的检索策略获取符合条件的记录。使用预先设定的标准对检索到的记录(n = 1272)进行筛选,最终得到21项全文研究以供审查。17项研究纳入了全文定性综合分析。7项研究的样本全部为非裔美国人,10项研究的样本为混合样本,其中包含非裔美国人亚组。非裔美国参与者的平均体重减轻幅度约为DPP干预组的一半。然而,由于高质量研究较少、样本量小以及干预设计和实施存在差异,难以对各干预措施进行比较。DPP转化研究在非裔美国成年人(尤其是女性)中的效果欠佳,这表明需要改进现有的循证干预措施,并开展更多高质量研究,纳入其他有风险的非裔美国人亚组,如男性和社会经济地位较低的年轻成年人。