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基于社区的参与式研究干预措施以改善糖尿病结局:系统评价。

Community-Based Participatory Research Interventions to Improve Diabetes Outcomes: A Systematic Review.

机构信息

Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.

Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin.

出版信息

Diabetes Educ. 2020 Dec;46(6):527-539. doi: 10.1177/0145721720962969. Epub 2020 Oct 14.

Abstract

PURPOSE

The purpose of this study was to conduct a systematic evaluation of community-based participatory research (CBPR) interventions on diabetes outcomes. Understanding of effective CBPR interventions on diabetes outcomes is limited, and findings remain unclear.

METHODS

A reproducible search strategy was used to identify studies testing CBPR interventions to improve diabetes outcomes, including A1C, fasting glucose, blood pressure, lipids, and quality of life. Pubmed, PsychInfo, and CINAHL were searched for articles published between 2010 and 2020. Using a CBPR continuum framework, studies were classified based on outreach, consulting, involving, collaborating, and shared leadership.

RESULTS

A total of 172 were screened, and a title search was conducted to determine eligibility. A total of 16 articles were included for synthesis. Twelve out of the 16 studies using CBPR approaches for diabetes interventions demonstrated statistically significant differences in 1 or more diabetes outcomes measured at a postintervention time point. Studies across the spectrum of CBPR demonstrated statistically significant improvements in diabetes outcomes.

CONCLUSIONS

Of the 16 studies included for synthesis, 14 demonstrated statistically significant changes in A1C, fasting glucose, blood pressure, lipids, and quality of life. The majority of studies used community health workers (CHWs) to deliver interventions across group and individual settings and demonstrated significant reductions in diabetes outcomes. The evidence summarized in this review shows the pivotal role that CHWs and diabetes care and education specialists play in not only intervention delivery but also in the development of outward-facing diabetes care approaches that are person- and community-centered.

摘要

目的

本研究旨在对基于社区的参与式研究(CBPR)干预措施对糖尿病结局的影响进行系统评价。目前,人们对有效 CBPR 干预措施对糖尿病结局影响的理解有限,研究结果尚不清楚。

方法

采用可重复的搜索策略,检索了测试 CBPR 干预措施以改善糖尿病结局(包括 A1C、空腹血糖、血压、血脂和生活质量)的研究。在 PubMed、PsychInfo 和 CINAHL 中搜索了 2010 年至 2020 年期间发表的文章。使用 CBPR 连续统一体框架,根据外展、咨询、参与、合作和共同领导,对研究进行分类。

结果

共筛选出 172 篇文章,并进行标题搜索以确定其是否符合纳入标准。最终有 16 篇文章被纳入进行综合分析。在 16 项使用 CBPR 方法进行糖尿病干预的研究中,有 12 项研究在干预后的某个时间点在 1 项或多项糖尿病结局测量中显示出统计学上的显著差异。在 CBPR 连续体的各个研究中均显示出糖尿病结局的统计学显著改善。

结论

在纳入综合分析的 16 项研究中,有 14 项研究在 A1C、空腹血糖、血压、血脂和生活质量方面显示出统计学上的显著变化。大多数研究使用社区卫生工作者(CHWs)在团体和个人环境中实施干预,并显示出糖尿病结局的显著降低。本综述中总结的证据表明,CHWs 和糖尿病护理和教育专家在不仅在干预措施的实施方面,而且在以患者和社区为中心的外向型糖尿病护理方法的开发方面发挥着关键作用。

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