Cioffi Catherine E, Ranjani Harish, Staimez Lisa R, Anjana Ranjit Mohan, Mohan Viswanathan, Weber Mary Beth
Nutrition and Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, USA.
Madras Diabetes Research Foundation, Chennai, India.
BMJ Open Diabetes Res Care. 2018 Oct 15;6(1):e000561. doi: 10.1136/bmjdrc-2018-000561. eCollection 2018.
We evaluated the effects of a diabetes prevention itervention on self-efficacy (SE) and the associations between SE and diabetes-related outcomes among overweight Asian Indian adults with pre-diabetes in a randomized controlled translational trial (the Diabetes Community Lifestyle Improvement Program, D-CLIP).
Data were obtained from 550 adults who were randomized to a diabetes prevention program or standard of care. Dietary and exercise-related SEs were measured at baseline, core intervention completion (4 months), and annually until the end of follow-up (3 years or diabetes diagnosis). Mixed-effects regressions described changes in SE over time by treatment group. Among treatment participants, multivariable-adjusted models described associations of SE at baseline and intervention completion with diabetes incidence and other secondary outcomes (weight, waist circumference (WC), exercise, and energy intake).
From baseline to 4 months, dietary (β=10.3, p=0.04) and exercise (β=0.49, p=0.04) SE increased significantly in the treatment arm only; however, this increase from baseline was no longer significant at later time points. Among treatment participants, there was no association of dietary or exercise SE with diabetes incidence, but baseline exercise SE was independently associated with improved weight, WC, and exercise at 4 months (p<0.05). Change in exercise SE from baseline to intervention completion also predicted increased exercise at 4, 12, and 24 months (p<0.05).
Exposure to D-CLIP resulted in improved SE at treatment completion, but this effect was not sustained over longer follow-up. Several short-term and long-term secondary outcomes, but not diabetes risk, were significantly associated with exercise SE, suggesting this psychosocial trait may facilitate success in achieving certain health goals.
NCT01283308.
在一项随机对照转化试验（糖尿病社区生活方式改善项目，D-CLIP）中，我们评估了糖尿病预防干预对超重的亚洲印度裔糖尿病前期成年人自我效能（SE）的影响，以及SE与糖尿病相关结局之间的关联。
数据来自550名被随机分配至糖尿病预防项目或常规护理的成年人。在基线、核心干预完成时（4个月）以及每年直至随访结束（3年或糖尿病诊断）时测量与饮食和运动相关的自我效能。混合效应回归描述了各治疗组自我效能随时间的变化。在治疗参与者中，多变量调整模型描述了基线和干预完成时的自我效能与糖尿病发病率及其他次要结局（体重、腰围（WC）、运动和能量摄入）之间的关联。
从基线到4个月，仅治疗组的饮食自我效能（β = 10.3，p = 0.04）和运动自我效能（β = 0.49，p = 0.04）显著增加；然而，从基线开始的这种增加在后续时间点不再显著。在治疗参与者中，饮食或运动自我效能与糖尿病发病率无关联，但基线运动自我效能与4个月时体重、腰围改善及运动独立相关（p < 0.05）。从基线到干预完成时运动自我效能的变化也预测了4、12和24个月时运动的增加（p < 0.05）。
参与D-CLIP在治疗完成时导致自我效能改善，但这种效果在更长的随访期内未持续。几个短期和长期次要结局与运动自我效能显著相关，但与糖尿病风险无关，这表明这种社会心理特征可能有助于实现某些健康目标。
NCT01283308。
