一项比较有效性随机对照试验的设计，该试验旨在测试针对美国马绍尔群岛人的基于信仰的糖尿病预防计划（WORD DPP）与太平洋文化适应性糖尿病预防计划（PILI DPP）。
Design of a comparative effectiveness randomized controlled trial testing a faith-based Diabetes Prevention Program (WORD DPP) vs. a Pacific culturally adapted Diabetes Prevention Program (PILI DPP) for Marshallese in the United States.
作者信息
McElfish Pearl Anna, Long Christopher R, Kaholokula Joseph Keawe'aimoku, Aitaoto Nia, Bursac Zoran, Capelle Lucy, Laelan Melisa, Bing Williamina Ioanna, Riklon Sheldon, Rowland Brett, Ayers Britni L, Wilmoth Ralph O, Langston Krista N, Schootman Mario, Selig James P, Yeary Karen Hye-Cheon Kim
机构信息
College of Medicine, University of Arkansas for Medical Sci10-1ences Northwest, 1125 N. College Avenue, Fayetteville, AR Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI Center for Pacific Islander Health, University of Arkansas for Medical Sciences Northwest, Fayetteville Division of Biostatistics, Department of Preventive Medicine, College of Medicine, University of Tennessee Health Science Center, TN Arkansas Coalition of Marshallese, Springdale, AR Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, MO; Department of Biostatistics College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR.
出版信息
Medicine (Baltimore). 2018 May;97(19):e0677. doi: 10.1097/MD.0000000000010677.
BACKGROUND
Pacific Islander populations, including Marshallese, face a disproportionately high burden of health disparities relative to the general population.
OBJECTIVES
A community-based participatory research (CBPR) approach was utilized to engage Marshallese participants in a comparative effectiveness trial testing 2 Diabetes Prevention Program (DPP) interventions designed to reduce participant's weight, lower HbA1c, encourage healthy eating, and increase physical activity.
DESIGN
To compare the effectiveness of the faith-based (WORD) DPP to the culturally adapted (Pacific Culturally Adapted Diabetes Prevention Program [PILI]) DPP, a clustered randomized controlled trial (RCT) with 384 Marshallese participants will be implemented in 32 churches located in Arkansas, Kansas, Missouri, and Oklahoma. Churches will be randomly assigned to WORD DPP arm or to PILI DPP arm.
METHODS
WORD DPP focuses on connecting faith and health to attain a healthy weight, eat healthy, and be more physically active. In contrast, PILI DPP is a family and community focused DPP curriculum specifically adapted for implementation in Pacific Islander communities. PILI focuses on engaging social support networks to maintain a healthy weight, eat healthy, and be more physically active. All participants are assessed at baseline, immediate post intervention, and 12 months post intervention.
SUMMARY
Both interventions aim to cause weight loss through improving physical activity and healthy eating, with the goal of preventing the development of T2D. The clustered RCT will determine which intervention is most effective with the Marshallese population. The utilization of a CBPR approach that involves local stakeholders and engages faith-based institutions in Marshallese communities will increase the potential for success and sustainability. This study is registered at clinicaltrials.gov (NCT03270436).
背景
包括马绍尔人在内的太平洋岛民群体，相对于普通人群，面临着不成比例的高健康差距负担。
目的
采用基于社区的参与性研究（CBPR）方法，让马绍尔参与者参与一项比较有效性试验，测试两种糖尿病预防计划（DPP）干预措施，旨在减轻参与者体重、降低糖化血红蛋白（HbA1c）、鼓励健康饮食并增加身体活动。
设计
为比较基于信仰的（WORD）DPP与文化适应性（太平洋文化适应性糖尿病预防计划 [PILI]）DPP的有效性，将在阿肯色州、堪萨斯州、密苏里州和俄克拉荷马州的32所教堂对384名马绍尔参与者实施一项整群随机对照试验（RCT）。教堂将被随机分配到WORD DPP组或PILI DPP组。
方法
WORD DPP专注于将信仰与健康联系起来，以达到健康体重、健康饮食并增加身体活动。相比之下，PILI DPP是一个以家庭和社区为重点的DPP课程，专门为在太平洋岛民社区实施而改编。PILI专注于利用社会支持网络来保持健康体重、健康饮食并增加身体活动。所有参与者在基线、干预后即刻和干预后12个月进行评估。
总结
两种干预措施都旨在通过改善身体活动和健康饮食来实现体重减轻，目标是预防2型糖尿病的发展。整群随机对照试验将确定哪种干预措施对马绍尔人群最有效。采用涉及当地利益相关者并让马绍尔社区的基于信仰的机构参与的CBPR方法，将增加成功和可持续性的可能性。本研究已在clinicaltrials.gov（NCT03270436）注册。
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