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万岁玛丽维尔!:一个基于社区的糖尿病预防的多层次、多部门模型。

¡Viva Maryvale!: A Multilevel, Multisector Model to Community-Based Diabetes Prevention.

机构信息

Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona.

Integrated Behavioral Health, Mountain Park Health Center, Phoenix, Arizona.

出版信息

Am J Prev Med. 2019 Jan;56(1):58-65. doi: 10.1016/j.amepre.2018.07.034.

Abstract

INTRODUCTION

Latino communities are disproportionately affected by type 2 diabetes and experience disparities in access to diabetes prevention programs. The purpose of this study was to test the preliminary efficacy of a culturally grounded, diabetes prevention program for high-risk Latino families delivered through an integrated research-practice partnership.

STUDY DESIGN

The integrated research-practice partnership was established in a predominantly Latino community and consisted of a Federally Qualified Health Center, a YMCA, an accredited diabetes education program, and an academic research center. Data were collected and analyzed from 2015 to 2018.

SETTING/PARTICIPANTS: Latino families consisting of a parent with an obese child between age 8 and 12 years.

INTERVENTION

The 12-week lifestyle intervention included nutrition education and behavioral skills training (60 minutes, once/week) and physical activity classes (60 minutes, three times/week) delivered at a YMCA.

MAIN OUTCOME MEASURES

Outcomes included measures of adiposity (BMI, waist circumference, and body fat); HbA1c; and weight-specific quality of life.

RESULTS

Over the course of the 2-year project period, 58 families (parents n=59, children n=68) were enrolled with 36% of parents and 29% of children meeting the criteria for prediabetes at baseline. Feasibility and acceptability were high, with 83% of enrolled families completing the program, 91% of the intervention sessions attended, and 100% of families stating they would recommend the program. The intervention led to significant decreases in percentage body fat among parents (46.4% [SD=10.8] to 43.5% [SD=10.5], p=0.001) as well as children (43.1% [SD=8.0] to 41.8% [SD=7.2], p=0.03). Additionally, HbA1c was significantly reduced in parents (5.6% [SD=0.4] to 5.5% [SD=0.3], p=0.03), and remained stable in children (5.5% [SD=0.3] vs 5.5% [SD=0.3], p>0.05). Significant improvements in quality of life were reported in parents (64.6 [SD=15.8] to 71.0 [SD=13.7], p=0.001) and children (69.7 [SD=15.8] to 72.6 [SD=13.7], p=0.05).

CONCLUSIONS

These findings support the preliminary efficacy of an integrated research-practice partnership to meet the diabetes prevention needs of high-risk Latino families within a vulnerable community.

摘要

简介

2 型糖尿病在拉丁裔群体中发病率较高,且在获得糖尿病预防项目方面存在差异。本研究旨在测试通过整合研究-实践伙伴关系为高风险拉丁裔家庭提供的、基于文化的糖尿病预防计划的初步效果,该计划根植于文化。

研究设计

整合研究-实践伙伴关系建立在一个以拉丁裔为主的社区,由联邦合格的健康中心、基督教青年会、认证的糖尿病教育计划和学术研究中心组成。数据收集和分析时间为 2015 年至 2018 年。

地点/参与者:父母一方肥胖,孩子年龄在 8 至 12 岁之间的拉丁裔家庭。

干预措施

为期 12 周的生活方式干预包括营养教育和行为技能培训(60 分钟,每周一次)和在基督教青年会进行的体育活动课(60 分钟,每周三次)。

主要观察指标

肥胖指标(BMI、腰围和体脂);HbA1c;体重特异性生活质量。

结果

在为期 2 年的项目期间,共纳入 58 个家庭(父母 59 人,儿童 68 人),36%的父母和 29%的儿童在基线时符合糖尿病前期标准。可行性和可接受性均较高,83%的入组家庭完成了该项目,91%的干预课程出席,100%的家庭表示愿意推荐该项目。该干预措施显著降低了父母的体脂百分比(46.4%[标准差=10.8]降至 43.5%[标准差=10.5],p=0.001)和儿童的体脂百分比(43.1%[标准差=8.0]降至 41.8%[标准差=7.2],p=0.03)。此外,父母的 HbA1c 也显著降低(5.6%[标准差=0.4]降至 5.5%[标准差=0.3],p=0.03),儿童的 HbA1c 则保持稳定(5.5%[标准差=0.3]与 5.5%[标准差=0.3],p>0.05)。父母(64.6[标准差=15.8]至 71.0[标准差=13.7],p=0.001)和儿童(69.7[标准差=15.8]至 72.6[标准差=13.7],p=0.05)的生活质量也有显著改善。

结论

这些发现支持了通过整合研究-实践伙伴关系满足弱势社区高风险拉丁裔家庭糖尿病预防需求的初步效果。

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