随机、文化适应、生活方式干预对中东移民心理健康的影响。

Effects of a randomized, culturally adapted, lifestyle intervention on mental health among Middle-Eastern immigrants.

机构信息

Department of Clinical Sciences, Lund University, Malmö, Sweden.

Department of Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

Eur J Public Health. 2019 Oct 1;29(5):888-894. doi: 10.1093/eurpub/ckz020.

DOI:10.1093/eurpub/ckz020

PMID:30809646

Abstract

BACKGROUND

Middle-Eastern immigrants in Sweden are at increased risk for type 2 diabetes (T2D) and poor mental health. Physical activity not only prevents/delays onset of T2D but also shows favorable effects on mental health. However, the effects of a culturally adapted lifestyle intervention on mental health among Middle-Eastern immigrants have not been explored before. We aimed to study the effects of a randomized controlled, culturally adapted lifestyle intervention on anxiety and depression levels in diabetes-prone Iraqi immigrants.

METHODS

Participants (n = 96) were randomized to intervention group, IG (n = 50) or control group, CG (n = 46). The IG received seven group sessions addressing lifestyle change and the CG received treatment as usual. Montgomery-Åsberg Depression Rating Scale (MADRS-S) and Hospital Anxiety and Depression Scale (HADS) assessed mental health at start, mid (2 months) and end of the study (4 months). Proportional odds ratio (OR) model was used to study the effect of the intervention.

RESULTS

The odds of scoring lower on MADRS-S and HADS depression scale at visit 3 vs. baseline were higher in the IG compared to the CG (MADRS-S OR 5.9, 95% CI: 1.6-22.5; HADS OR 4.4, 95% CI: 0.9-20.3). The findings persisted after adjustment for age, sex, body mass index, time since migration, sedentary lifestyle and language spoken at home. Group differences were non-significant at visit 2 vs. baseline.

CONCLUSION

A culturally adapted lifestyle intervention addressing T2D prevention in Middle-Eastern immigrants has favorable effects on mental health. The effect was more pronounced at the 4 months than at 2 months follow-up, indicating beneficial effect of longer study duration.

TRIAL REGISTRATION

www.clinicaltrials.gov NCT01420198.

摘要

背景

在瑞典，中东移民患 2 型糖尿病（T2D）和精神健康不良的风险增加。身体活动不仅可以预防/延迟 T2D 的发生，而且对精神健康也有有利影响。然而，以前尚未探讨过针对中东移民的文化适应性生活方式干预对精神健康的影响。我们旨在研究一项随机对照、文化适应性生活方式干预对易患糖尿病的伊拉克移民焦虑和抑郁水平的影响。

方法

参与者（n=96）随机分为干预组（IG，n=50）或对照组（CG，n=46）。IG 接受了七次小组会议，内容涉及生活方式改变，而 CG 则接受了常规治疗。采用蒙哥马利-阿斯伯格抑郁评定量表（MADRS-S）和医院焦虑抑郁量表（HADS）在研究开始时、中期（2 个月）和结束时（4 个月）评估心理健康状况。使用比例优势比（OR）模型研究干预的效果。

结果

与 CG 相比，IG 在第 3 次就诊时（与基线相比）MADRS-S 和 HADS 抑郁量表评分较低的几率更高（MADRS-S OR 5.9，95%CI：1.6-22.5；HADS OR 4.4，95%CI：0.9-20.3）。调整年龄、性别、体重指数、移民时间、久坐不动的生活方式和在家中所说的语言后，结果仍然存在。IG 与 CG 相比，第 2 次就诊时与基线相比无显著差异。