Wagner Julie, Kong Sengly, Kuoch Theanvy, Scully Mary F, Tan Heang Kim, Bermudez-Millan Angela
J Health Care Poor Underserved. 2015 May;26(2):441-52. doi: 10.1353/hpu.2015.0029.
This study investigated a community health worker-delivered lifestyle intervention for prevention of cardiometabolic disease, called Eat, Walk, Sleep. It was designed for traumatized, low-literacy Cambodian American refugees.
We used a single group, pre-post design to evaluate the effects of the program on self-reported health behaviors. As a control for threats to internal validity, we also measured a nonequivalent dependent variable, i.e., perceived discrimination by health care providers.
Of 140 participants enrolled, 114 completed one-year assessments. In intent-to-treat analysis with correction for multiple comparisons, compared with baseline, participants at one year scored higher on cardiometabolic prevention knowledge, self-rated health, physical activity, medication compliance, and preventive screenings, and they reported improved sleep, a modest shift from white to brown rice, and reduced barriers to care. As expected, perceptions of discrimination by health care providers did not change.
Self-reported behavioral risk factors improved. A randomized, controlled study with objective measures is warranted.
本研究调查了一种由社区卫生工作者提供的预防心脏代谢疾病的生活方式干预措施，称为“饮食、步行、睡眠”。该措施是为受创伤、文化程度低的柬埔寨裔美国难民设计的。
我们采用单组前后测设计来评估该项目对自我报告的健康行为的影响。作为对内部效度威胁的控制，我们还测量了一个非对等的因变量，即医疗服务提供者的感知歧视。
在140名登记参与者中，114人完成了一年的评估。在进行多重比较校正的意向性分析中，与基线相比，参与者在一年时在心脏代谢预防知识、自我健康评分、身体活动、药物依从性和预防性筛查方面得分更高，他们报告睡眠改善，从白米到糙米的适度转变，以及就医障碍减少。正如预期的那样，医疗服务提供者的歧视感知没有变化。
自我报告的行为风险因素有所改善。有必要进行一项采用客观测量方法的随机对照研究。
