Lutes Lesley D, Cummings Doyle M, Littlewood Kerry, Dinatale Emily, Hambidge Bertha
Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada.
Department of Family Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
Obesity (Silver Spring). 2017 Aug;25(8):1329-1335. doi: 10.1002/oby.21883. Epub 2017 Jun 29.
To evaluate the effectiveness of a community health worker (CHW)-delivered lifestyle intervention for African American women with type 2 diabetes.
Participants were randomized to either 16 phone-based lifestyle intervention sessions aimed at making small changes in their diet and activity or 16 educational mailings sent across 12 months. Main outcomes included glycosylated hemoglobin (HbA1c), blood pressure (BP), and weight (kg) changes.
Two hundred middle-aged (mean = 53 ± 10.24 years), rural, African American women with moderate obesity (mean BMI = 37.7 ± 8.02) and type 2 diabetes (mean HbA1c = 9.1 ± 1.83) were enrolled. At 12 months, the intervention group exhibited no significant differences in HbA1c (-0.29 ± 1.84 vs. + 0.005 ± 1.61; P = 0.789) or BP (-1.01 ± 20.46/+0.66 ± 13.24 vs. + 0.22 ± 25.33/-2.87 ± 1.52; P = 0.100) but did exhibit greater weight loss (-1.35 ± 6.22 vs. -0.39 ± 4.57 kg, respectively; P = 0.046) compared with controls. Exploratory post hoc analyses revealed that participants not using insulin had significantly greater reductions in HbA1c (-0.70 ± 1.86 vs. + 0.07 ± 2.01; P = 0.000), diastolic BP (-5.17 ± 14.16 vs. -3.40 ± 14.72 mmHg; P = 0.035), and weight (-2.36 ± 6.59 vs. -1.64 ± 4.36 kg; P = 0.003) compared to controls not on insulin.
A phone-based CHW intervention resulted in no significant improvements in HbA1c or BP but did demonstrate modest improvements in weight. Women not using insulin showed significant improvements in all primary outcomes.
评估社区卫生工作者（CHW）提供的生活方式干预对非裔美国2型糖尿病女性的有效性。
参与者被随机分为两组，一组接受为期16次的电话生活方式干预，旨在对其饮食和活动进行微小改变；另一组在12个月内收到16份教育邮件。主要结局包括糖化血红蛋白（HbA1c）、血压（BP）和体重（kg）的变化。
招募了200名中年（平均年龄=53±10.24岁）、农村、中度肥胖（平均BMI=37.7±8.02）且患有2型糖尿病（平均HbA1c=9.1±1.83）的非裔美国女性。在12个月时，干预组在HbA1c（-0.29±1.84 vs.+0.005±1.61；P=0.789）或血压（-1.01±20.46/+0.66±13.24 vs.+0.22±25.33/-2.87±1.52；P=0.100）方面无显著差异，但与对照组相比，体重减轻更明显（分别为-1.35±6.22 vs.-0.39±4.57 kg；P=0.046）。探索性事后分析显示，未使用胰岛素的参与者在HbA1c（-0.70±1.86 vs.+0.07±2.01；P=0.000）、舒张压（-5.17±14.16 vs.-3.40±14.72 mmHg；P=0.035）和体重（-2.36±6.59 vs.-1.64±4.36 kg；P=0.003）方面的降低幅度显著大于未使用胰岛素的对照组。
基于电话的CHW干预在HbA1c或血压方面未带来显著改善，但在体重方面有适度改善。未使用胰岛素的女性在所有主要结局方面均有显著改善。
