Lynch Elizabeth, Mack Laurin J, Karavolos Kelly, Avery Elizabeth, Liebman Rebecca, Keim Kathryn S, Glover Crystal M, Fogelfeld Leon
J Health Care Poor Underserved. 2017;28(1):463-486. doi: 10.1353/hpu.2017.0034.
African Americans experience poorer diabetes outcomes than non-Hispanic Whites. Few clinical trials of diabetes self-management interventions specifically target African Americans, perhaps due to well-documented barriers to recruitment in this population. This paper describes strategies used to successfully recruit 211 low-income African Americans from community clinics of a large, urban public hospital system to a randomized clinical trial of an 18-month diabetes self-management intervention. Diabetes-related physiological, psychosocial, and behavioral characteristics of the sample are reported. The sample was 77% female, mean age = 55, mean A1C = 8.5%, 39% low health literacy, 28.4% moderate/severe depression, and 48.3% low adherence. Participants ate a high-fat diet with low vegetable consumption. Relative to males, females had higher BMI, depression, and stress, and better glycemic control, less physical activity, and less alcohol consumption. Males consumed more daily calories, but females consumed a greater proportion of carbohydrates. Gender-specific diabetes self-management strategies may be warranted in this population.
非裔美国人的糖尿病治疗效果比非西班牙裔白人更差。很少有糖尿病自我管理干预的临床试验专门针对非裔美国人，这可能是由于该人群中存在有充分记录的招募障碍。本文描述了从一个大型城市公立医院系统的社区诊所成功招募211名低收入非裔美国人参加一项为期18个月的糖尿病自我管理干预随机临床试验所采用的策略。报告了样本的糖尿病相关生理、心理社会和行为特征。样本中77%为女性，平均年龄 = 55岁，平均糖化血红蛋白（A1C）= 8.5%，39%健康素养低，28.4%有中度/重度抑郁，48.3%依从性低。参与者饮食中脂肪含量高，蔬菜摄入量低。相对于男性，女性的体重指数（BMI）、抑郁程度和压力更高，血糖控制更好，身体活动较少，饮酒较少。男性每日摄入的卡路里更多，但女性摄入的碳水化合物比例更高。在这一人群中可能需要针对性别制定糖尿病自我管理策略。
