Rowther Armaan A, Dykzeul Brad, Billimek John, Abuhassan Deyana, Anderson Craig, Lotfipour Shahram
Johns Hopkins University School of Medicine.
Department of Emergency Medicine, University of California-Irvine School of Medicine.
J Glob Health Perspect. 2015;2015. Epub 2015 Oct 27.
The prevalence of diabetes in the Middle East is increasing rapidly due to urbanization, reduced levels of physical activity, and a nutritional transition toward increased consumption of fats and refined carbohydrates. Preventive strategies are of paramount importance to stemming the tide. Portable touch-screen computer technology may hold an answer for alleviating the burdens of cost, time, and training that limit the implementation of diabetes risk screening and intervention, especially among refugees and other vulnerable populations. The Computer-Assisted Diabetes Risk Assessment and Education (CADRAE) Arabic-language intervention program is proposed as a model method for practicing proactive type 2 diabetes prevention in resource-limited settings of the Middle East that combines the efficiency of risk-score screening methods, the advantages of portable computer interface, and the spirit of brief motivational interviewing. This paper aims to describe the theory and novel design of CADRAE-introduced at the Noor Al Hussein Foundation's Institute of Family Health in January 2014-as well as discuss opportunities and challenges for its implementation and evaluation in primary or emergency care settings. Features of CADRAE are elucidated in detail, including development, translation, conceptual framework, theoretical basis, method of risk assessment, brief intervention style, definition of outcomes, requirements for implementation, and potential means of evaluation and quality improvement. CADRAE offers the first example of portable computer technology integrating diabetes risk screening with behavior change counseling tailored for an Arabic-speaking population of mostly refugees and could offer a valuable model for researchers and policy makers of the Middle East as well as other resource-limited settings.
由于城市化、身体活动水平降低以及营养结构向脂肪和精制碳水化合物消费增加的转变，中东地区糖尿病的患病率正在迅速上升。预防策略对于遏制这一趋势至关重要。便携式触摸屏计算机技术可能为减轻成本、时间和培训负担提供解决方案，这些负担限制了糖尿病风险筛查和干预措施的实施，尤其是在难民和其他弱势群体中。计算机辅助糖尿病风险评估与教育（CADRAE）阿拉伯语干预项目被提议作为一种在中东资源有限环境中积极预防2型糖尿病的示范方法，该方法结合了风险评分筛查方法的效率、便携式计算机界面的优势以及简短动机访谈的理念。本文旨在描述2014年1月在努尔·侯赛因基金会家庭健康研究所引入的CADRAE的理论和新颖设计，并讨论在初级或急诊护理环境中实施和评估该项目的机遇与挑战。详细阐述了CADRAE的特点，包括开发、翻译、概念框架、理论基础、风险评估方法、简短干预方式、结果定义、实施要求以及潜在的评估和质量改进手段。CADRAE首次展示了便携式计算机技术将糖尿病风险筛查与为以阿拉伯语为主要语言的难民群体量身定制的行为改变咨询相结合的实例，可为中东地区以及其他资源有限环境中的研究人员和政策制定者提供有价值的模式。
