Bukman Andrea J, Duijzer Geerke, Haveman-Nies Annemien, Jansen Sophia C, Ter Beek Josien, Hiddink Gerrit J, Feskens Edith J M
Wageningen University, Division of Human Nutrition, P.O Box 17, 6700 AA Wageningen, The Netherlands.
Wageningen University, Division of Human Nutrition, P.O Box 17, 6700 AA Wageningen, The Netherlands; GGD Noord- en Oost-Gelderland (Community Health Service), P.O Box 3, 7200 AA Zutphen, The Netherlands.
Diabetes Res Clin Pract. 2017 Jul;129:160-168. doi: 10.1016/j.diabres.2017.05.002. Epub 2017 May 10.
To explore the role of socioeconomic status (SES) in participation, programme attendance, programme acceptability, adherence to lifestyle guidelines, drop-out, and effectiveness in the SLIMMER diabetes prevention intervention.
SLIMMER was a randomised controlled intervention, carried out in a real-world setting, targeting 40- to 70-year-old adults at increased risk of developing type 2 diabetes (n=316). The intervention group participated in a 10-month combined dietary and physical activity programme. Measurements were carried out at baseline, 12months, and 18months. Effectiveness was determined for fasting insulin, HbA1c, weight, BMI, waist circumference, and waist-to-height-ratio. Differences between the low SES (no, primary, or lower secondary school) and higher SES group were tested using logistic regression and ANCOVA.
Fifty-two percent of the SLIMMER participants had a low SES. No differences in participation were observed between the low and higher SES group. The most important reason for non-participation in the low SES group was 'lack of interest' (32%), whereas in the higher SES group this was 'I already exercise enough' (31%). Attendance, acceptability, adherence, drop-out, and effectiveness after 12months were similar in the low and higher SES group. After 18months, the low SES group seemed to maintain slightly better effects for fasting insulin, HbA1c, and waist circumference.
The current study showed that participation, attendance, acceptability, adherence, drop-out, and effectiveness of the SLIMMER intervention were in general not modified by socioeconomic status. The SLIMMER intervention can contribute to health promotion for individuals in both low and higher socioeconomic groups.
探讨社会经济地位（SES）在“SLIMMER糖尿病预防干预措施”中的参与度、项目参与率、项目可接受性、对生活方式指南的依从性、退出率及有效性方面所起的作用。
“SLIMMER”是一项在现实环境中开展的随机对照干预研究，针对有患2型糖尿病风险增加的40至70岁成年人（n = 316）。干预组参加了为期10个月的饮食与体育活动综合项目。在基线、12个月和18个月时进行测量。测定空腹胰岛素、糖化血红蛋白（HbA1c）、体重、体重指数（BMI）、腰围和腰高比的有效性。使用逻辑回归和协方差分析检验低社会经济地位（未接受教育、小学或初中）组与高社会经济地位组之间的差异。
“SLIMMER”参与者中有52%社会经济地位较低。低社会经济地位组和高社会经济地位组在参与度上未观察到差异。低社会经济地位组不参与的最重要原因是“缺乏兴趣”（32%），而高社会经济地位组是“我已经运动得足够多了”（31%）。低社会经济地位组和高社会经济地位组在12个月后的参与率、可接受性、依从性、退出率和有效性相似。18个月后，低社会经济地位组在空腹胰岛素、糖化血红蛋白和腰围方面似乎保持着稍好的效果。
当前研究表明，“SLIMMER”干预措施的参与度、参与率、可接受性、依从性、退出率和有效性总体上不受社会经济地位的影响。“SLIMMER”干预措施可为社会经济地位较低和较高群体的个人促进健康做出贡献。
