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比较电话和群体提供的糖尿病预防项目:有妊娠期糖尿病史的参与和未参与产后母亲的特征。

Comparing a telephone- and a group-delivered diabetes prevention program: Characteristics of engaged and non-engaged postpartum mothers with a history of gestational diabetes.

作者信息

Lim Siew, Dunbar James A, Versace Vincent L, Janus Edward, Wildey Carol, Skinner Timothy, O'Reilly Sharleen

机构信息

Faculty of Health, School of Medicine, Deakin Rural Health, Warrnambool, Victoria, Australia; Health Systems Improvement Unit, Centre for Population Health, School of Health and Social Development, Deakin University, VIC, Australia.

Centre for Population Health Research, Deakin University, VIC, Australia.

出版信息

Diabetes Res Clin Pract. 2017 Apr;126:254-262. doi: 10.1016/j.diabres.2017.02.026. Epub 2017 Feb 27.

Abstract

AIMS

To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement.

METHODS

Postpartum women participated in a lifestyle modification program delivered by telephone (n=33) or group format (n=284). Semi-structured interviews on barriers and enablers to program engagement (defined as completing≥80% sessions) were conducted before (Group) and after (Group and Telephone) interventions. The Health Action Process Approach theory was used as the framework for inquiry. Psychological measures were compared between engagement subgroups before and after group-delivered intervention.

RESULTS

In the telephone-delivered program 82% participants met the engagement criteria compared with 38% for the group-delivered program. Engaged participants (Group) had significantly higher risk perception, outcome expectancy, and activity self-efficacy at baseline (P<0.05). There was a greater decrease in body weight (-1.45±3.9 vs -0.26±3.5, P=0.024) and waist circumference (-3.56±5.1 vs -1.24±5.3, P=0.002) for engaged vs non-engaged participants following group program completion.

CONCLUSIONS

Telephone delivery was associated with greater engagement in postpartum women. Engagement was associated with greater reduction in weight and waist circumference. Further studies are required to confirm the effectiveness of telephone-delivered program for diabetes prevention in postpartum women.

摘要

目的

探讨电话或小组形式提供的糖尿病预防项目对有既往妊娠期糖尿病史女性的可接受性,并比较与项目参与相关的特征。

方法

产后女性参与了通过电话(n = 33)或小组形式(n = 284)提供的生活方式改变项目。在干预前(小组形式组)和干预后(小组形式组和电话组)进行了关于项目参与障碍和促进因素(定义为完成≥80%的课程)的半结构化访谈。健康行动过程方法理论被用作探究框架。在小组形式干预前后,对参与亚组之间的心理测量指标进行了比较。

结果

在电话提供的项目中,82%的参与者达到了参与标准,而小组形式提供的项目这一比例为38%。参与的参与者(小组形式组)在基线时的风险感知、结果期望和活动自我效能显著更高(P<0.05)。在小组项目完成后,参与项目的参与者与未参与项目的参与者相比,体重下降幅度更大(-1.45±3.9 vs -0.26±3.5,P = 0.024),腰围下降幅度更大(-3.56±5.1 vs -1.24±5.3,P = 0.002)。

结论

电话形式与产后女性更高的参与度相关。参与度与体重和腰围的更大幅度下降相关。需要进一步研究来证实电话提供的项目对产后女性预防糖尿病的有效性。

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