Kitzman Heather, Dodgen Leilani, Mamun Abdullah, Slater J Lee, King George, Slater Donna, King Alene, Mandapati Surendra, DeHaven Mark
Baylor Scott & White Health and Wellness Center, Baylor Scott & White Health, 4500 Spring Ave, Dallas, TX 75210, United States.
School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States.
Contemp Clin Trials. 2017 Nov;62:77-90. doi: 10.1016/j.cct.2017.08.003. Epub 2017 Aug 12.
Reducing obesity positively impacts diabetes and cardiovascular risk; however, evidence-based lifestyle programs, such as the diabetes prevention program (DPP), show reduced effectiveness in African American (AA) women. In addition to an attenuated response to lifestyle programs, AA women also demonstrate high rates of obesity, diabetes, and cardiovascular disease. To address these disparities, enhancements to evidence-based lifestyle programs for AA women need to be developed and evaluated with culturally relevant and rigorous study designs. This study describes a community-based participatory research (CBPR) approach to design a novel faith-enhancement to the DPP for AA women. A long-standing CBPR partnership designed the faith-enhancement from focus group data (N=64 AA adults) integrating five components: a brief pastor led sermon, memory verse, in class or take-home faith activity, promises to remember, and scripture and prayer integrated into participant curriculum and facilitator materials. The faith components were specifically linked to weekly DPP learning objectives to strategically emphasize behavioral skills with religious principles. Using a CBPR approach, the Better Me Within trial was able to enroll 12 churches, screen 333 AA women, and randomize 221 (M=48.8±11.2; M=36.7±8.4; 52% technical or high school) after collection of objective eligibility measures. A prospective, randomized, nested by church, design will be used to evaluate the faith-enhanced DPP as compared to a standard DPP on weight, diabetes and cardiovascular risk, over a 16-week intervention and 10-month follow up. This study will provide essential data to guide enhancements to evidence-based lifestyle programs for AA women who are at high risk for chronic disease.
减轻肥胖对糖尿病和心血管疾病风险有积极影响;然而,诸如糖尿病预防计划(DPP)等基于证据的生活方式项目在非裔美国(AA)女性中显示出较低的有效性。除了对生活方式项目的反应减弱外,AA女性还表现出肥胖、糖尿病和心血管疾病的高发病率。为了解决这些差异,需要采用与文化相关且严谨的研究设计来开发和评估针对AA女性的基于证据的生活方式项目的改进措施。本研究描述了一种基于社区的参与性研究(CBPR)方法,用于为AA女性设计一种新颖的对DPP的信仰强化方案。一个长期的CBPR合作伙伴关系根据焦点小组数据(N = 64名AA成年人)设计了这种信仰强化方案,该方案整合了五个组成部分:牧师简短的布道、记忆经文、课堂或带回家的信仰活动、要记住的承诺,以及融入参与者课程和 facilitator 材料中的经文和祈祷。这些信仰组成部分与每周的DPP学习目标具体相关联,以便从战略上强调宗教原则下的行为技能。采用CBPR方法,“内在更好的我”试验能够招募12个教堂,筛查333名AA女性,并在收集客观合格指标后将221名女性随机分组(M = 48.8±11.2;M = 36.7±8.4;52%为技术或高中水平)。在为期16周的干预和10个月的随访期间,将采用前瞻性、随机、按教堂嵌套的设计,将这种信仰强化的DPP与标准DPP在体重、糖尿病和心血管疾病风险方面进行比较评估。本研究将提供重要数据,以指导针对慢性病高危AA女性的基于证据的生活方式项目的改进。