Kollannoor-Samuel Grace, Shebl Fatma M, Segura-Pérez Sofia, Chhabra Jyoti, Vega-López Sonia, Pérez-Escamilla Rafael
Grace Kollannoor-Samuel, Fatma M. Shebl, and Rafael Pérez-Escamilla are with the Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT. Sofia Segura-Pérez is with the Center for Community Nutrition, Hispanic Health Council, Hartford, CT. Jyoti Chhabra is with Hartford Hospital, Hartford, CT. Sonia Vega-López is with the School of Nutrition and Health Promotion, Arizona State University, Phoenix.
Am J Public Health. 2016 Jun;106(6):1059-66. doi: 10.2105/AJPH.2016.303091. Epub 2016 Apr 14.
To determine the impact of an intervention led by community health workers (CHWs) on food label use and to assess whether food label use and diet quality mediate the intervention's impact on glycemic control.
From 2006 to 2010, 203 Latinos (intervention group, n = 100; control group, n = 103) in Hartford County, Connecticut, with type 2 diabetes were randomized to an intervention that included 17 CHW-led home-based sessions over a 12-month period in addition to the standard of care available in both study arms. Data on food label use, diet quality, covariates, and glycated hemoglobin (HbA1c) were collected at baseline and at 3, 6, 12, and 18 months. Data were analyzed via mixed effects and multilevel structural equation modeling.
Food label use in the intervention (vs control) group was significantly higher at 3, 12, and 18 months (odds ratio = 2.99; 95% confidence interval = 1.69, 5.29). Food label use and diet quality were positive mediators of improved HbA1c levels.
Culturally tailored interventions led by CHWs could increase food label use. Also, CHW-delivered food label education may lead to better diet quality and improve glycemic control among Latinos with type 2 diabetes.
确定社区卫生工作者（CHW）主导的干预措施对食品标签使用的影响，并评估食品标签使用和饮食质量是否介导了该干预措施对血糖控制的影响。
2006年至2010年，康涅狄格州哈特福德县的203名患有2型糖尿病的拉丁裔（干预组，n = 100；对照组，n = 103）被随机分配到一项干预措施中，该干预措施除了两个研究组都有的标准治疗外，还包括在12个月内由CHW主导的17次家访。在基线以及3、6、12和18个月时收集有关食品标签使用、饮食质量、协变量和糖化血红蛋白（HbA1c）的数据。通过混合效应和多级结构方程模型对数据进行分析。
在3、12和18个月时，干预组（与对照组相比）的食品标签使用显著更高（优势比 = 2.99；95%置信区间 = 1.69, 5.29）。食品标签使用和饮食质量是HbA1c水平改善的正向中介因素。
由CHW主导的文化适应性干预措施可增加食品标签的使用。此外，由CHW提供的食品标签教育可能会带来更好的饮食质量，并改善患有2型糖尿病的拉丁裔的血糖控制。
