Ahn SangNam, Lee Joonhyung, Bartlett-Prescott Jenny, Carson Lisa, Post Lindsey, Ward Kenneth D
1 Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN, USA.
2 Fogelman College of Business and Economics, The University of Memphis, Memphis, TN, USA.
Am J Health Promot. 2018 Feb;32(2):409-422. doi: 10.1177/0890117117696250. Epub 2017 Mar 9.
To examine the effects of a community-based behavioral intervention with multiple components on health outcomes among low-income and uninsured adults who were obese and had diabetes and treated in a "real-world" setting.
A longitudinal design with a retrospective comparison group was used to examine the ability of a health promotion program to improve body mass index (BMI) and hemoglobin A1c (HbA1c) among 87 treatment group and 62 comparison group participants.
Urban/metropolitan city in the United States.
A community-based behavioral intervention with 3 components including health-coach visits, registered dietitian visits, and exercise consultations delivered over 12 months.
Biometric measurements were collected at baseline, 3, 6, 9, 12, and 18 months, whereas self-reported measurements were collected at baseline, 6 months, and 12 months.
Linear mixed models with participant-level random intercepts were fitted for BMI and HbA1c.
The treatment group demonstrated reductions in BMI (percentage change = -2.1%, P < .001) and HbA1c (-0.6%, P < .001) as well as improvement in diabetes knowledge (+5.4%, P = .025), whereas the comparison group did not show any improvements in biometric measures. Dietitian visits were the most effective treatment component to reduce HbA1c (coefficient = -0.08, P = .025).
Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.
研究一项多组分社区行为干预措施对在“真实世界”环境中接受治疗的肥胖且患有糖尿病的低收入未参保成年人健康结局的影响。
采用带有回顾性对照组的纵向设计，以检验一项健康促进项目在87名治疗组参与者和62名对照组参与者中改善体重指数（BMI）和糖化血红蛋白（HbA1c）的能力。
美国的城市/大都市。
一项为期12个月的多组分社区行为干预措施，包括健康教练家访、注册营养师家访和运动咨询。
在基线、3个月、6个月、9个月、12个月和18个月时收集生物测量数据，而在基线、6个月和12个月时收集自我报告数据。
对BMI和HbA1c采用带有参与者水平随机截距的线性混合模型。
治疗组的BMI（百分比变化=-2.1%，P<.001）和HbA1c（-0.6%，P<.001）降低，糖尿病知识得到改善（+5.4%，P=.025），而对照组在生物测量指标上未显示任何改善。营养师家访是降低HbA1c最有效的治疗组分（系数=-0.08，P=.025）。
社区环境中的多组分行为干预，特别是由注册营养师实施时，有望应对低收入未参保患者中肥胖和糖尿病的双重流行。
