技术增强型同伴支持在改善以非裔美国人为主体、糖尿病低收入成年人血糖管理方面的效果。
Effectiveness of Technologically Enhanced Peer Support in Improving Glycemic Management Among Predominantly African American, Low-Income Adults With Diabetes.
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, and Center for Clinical Management Research, Ann Arbor Veterans Affairs (VA) Healthcare System, Ann Arbor, Michigan.
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, and Michigan Center for Diabetes Translation Research (MCDTR), University of Michigan, Ann Arbor VA, Ann Arbor, Michigan.
出版信息
Diabetes Educ. 2019 Jun;45(3):260-271. doi: 10.1177/0145721719844547. Epub 2019 Apr 26.
PURPOSE
The purpose of the study was to examine whether a peer coaching intervention is more effective in improving clinical outcomes in diabetes when enhanced with e-health educational tools than peer coaching alone.
METHODS
The effectiveness of peer coaches who used an individually tailored, interactive, web-based tool (iDecide) was compared with peer coaches with no access to the tool. Two hundred and ninety Veterans Affairs patients with A1C ≥8.0% received a 6-month intervention with an initial session with a fellow patient trained to be a peer coach, followed by weekly phone calls to discuss behavioral goals. Participants were randomized to coaches who used iDecide or coaches who used nontailored educational materials at the initial session. Outcomes were A1C (primary), blood pressure, and diabetes social support (secondary) at 6 and 12 months.
RESULTS
Two hundred and fifty-five participants (88%) completed 6-month and 237 (82%) 12-month follow-up. Ninety-eight percent were men, and 63% were African American. Participants in both groups improved A1C values (>-0.6%, P < .001) at 6 months and maintained these gains at 12-month follow-up ( >-0.5%, P < .005). Diabetes social support was improved at both 6 and 12 months ( P < .01). There were no changes in blood pressure.
CONCLUSIONS
Clinical gains achieved through a volunteer peer coach program were not increased by the addition of a tailored e-health educational tool.
目的
本研究旨在考察同伴教练干预在强化电子健康教育工具的情况下，是否比单纯的同伴教练干预更能有效改善糖尿病的临床结局。
方法
比较了使用个性化、互动式网络工具（iDecide）的同伴教练与无法使用该工具的同伴教练的效果。290 名 A1C≥8.0%的退伍军人接受了为期 6 个月的干预，初始阶段与接受过同伴教练培训的患者进行了一次会面，随后每周通过电话讨论行为目标。参与者被随机分配给使用 iDecide 的教练或在初始阶段使用非定制教育材料的教练。主要结局是 6 个月和 12 个月时的 A1C（主要结局）、血压和糖尿病社会支持（次要结局）。
结果
255 名参与者（88%）完成了 6 个月和 237 名（82%）12 个月的随访。98%为男性，63%为非裔美国人。两组参与者的 A1C 值均有所改善（>-0.6%，P<.001），且在 12 个月的随访中保持了这些改善（>-0.5%，P<.005）。6 个月和 12 个月时，糖尿病社会支持均有所改善（P<.01）。血压没有变化。
结论
通过志愿者同伴教练计划取得的临床收益，并未因添加定制化的电子健康教育工具而增加。
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