Hawley Caitlin N, Huber Corrine M, Best Lyle G, Howard Barbara V, Umans Jason, Beresford Shirley A A, McKnight Barbara, Hager Arlette, O'Leary Marcia, Thorndike Anne N, Ornelas India J, Brown Meagan C, Fretts Amanda M
Department of Medicine, University of Washington, 1410 NE Campus Parkway, Seattle, WA, 98195, USA.
Missouri Breaks Industries Research Inc, 118 S Willow St, Eagle Butte, SD, 57625, USA.
BMC Public Health. 2021 Feb 15;21(1):356. doi: 10.1186/s12889-021-10308-8.
The prevalence of poor diet quality and type 2 diabetes are exceedingly high in many rural American Indian (AI) communities. Because of limited resources and infrastructure in some communities, implementation of interventions to promote a healthy diet is challenging-which may exacerbate health disparities by region (urban/rural) and ethnicity (AIs/other populations). It is critical to adapt existing evidence-based healthy food budgeting, purchasing, and cooking programs to be relevant to underserved populations with a high burden of diabetes and related complications. The Cooking for Health Study will work in partnership with an AI community in South Dakota to develop a culturally-adapted 12-month distance-learning-based healthy food budgeting, purchasing, and cooking intervention to improve diet among AI adults with type 2 diabetes.
The study will enroll 165 AIs with physician-diagnosed type 2 diabetes who reside on the reservation. Participants will be randomized to an intervention or control arm. The intervention arm will receive a 12-month distance-learning curriculum adapted from Cooking Matters® that focuses on healthy food budgeting, purchasing, and cooking skills. In-person assessments at baseline, month 6 and month 12 will include completion of the Nutrition Assessment Shared Resources Food Frequency Questionnaire and a survey to assess frequency of healthy and unhealthy food purchases. Primary outcomes of interest are: (1) change in self-reported intake of sugar-sweetened beverages (SSBs); and (2) change in the frequency of healthy and unhealthy food purchases. Secondary outcomes include: (1) change in self-reported food budgeting skills; (2) change in self-reported cooking skills; and (3) a mixed-methods process evaluation to assess intervention reach, fidelity, satisfaction, and dose delivered/received.
Targeted and sustainable interventions are needed to promote optimal health in rural AI communities. If effective, this intervention will reduce intake of SSBs and the purchase of unhealthy foods; increase the purchase of healthy foods; and improve healthy food budgeting and cooking skills among AIs with type 2 diabetes - a population at high risk of poor health outcomes. This work will help inform future health promotion efforts in resource-limited settings.
This study was registered on ClinicalTrials.gov on October 9, 2018 with Identifier NCT03699709 .
在美国许多农村印第安人（AI）社区，不良饮食质量和2型糖尿病的患病率极高。由于一些社区资源和基础设施有限，实施促进健康饮食的干预措施具有挑战性，这可能会加剧地区（城市/农村）和种族（AI/其他人群）之间的健康差距。使现有的基于证据的健康食品预算、采购和烹饪计划适用于糖尿病及相关并发症负担较重的服务不足人群至关重要。“健康烹饪研究”将与南达科他州的一个AI社区合作，开发一个基于文化适应的、为期12个月的远程学习健康食品预算、采购和烹饪干预措施，以改善患有2型糖尿病的AI成年人的饮食。
该研究将招募165名居住在保留地且经医生诊断患有2型糖尿病的AI。参与者将被随机分配到干预组或对照组。干预组将接受为期12个月的改编自“烹饪重要事项”的远程学习课程，该课程侧重于健康食品预算、采购和烹饪技能。在基线、第6个月和第12个月进行的现场评估将包括完成营养评估共享资源食物频率问卷以及一项评估健康和不健康食品购买频率的调查。感兴趣的主要结果是：（1）自我报告的含糖饮料（SSB）摄入量的变化；（2）健康和不健康食品购买频率的变化。次要结果包括：（1）自我报告的食品预算技能的变化；（2）自我报告的烹饪技能的变化；（3）一项混合方法过程评估，以评估干预的覆盖范围、保真度、满意度以及提供/接受的剂量。
需要有针对性的可持续干预措施来促进农村AI社区的最佳健康。如果有效，该干预措施将减少SSB的摄入量和不健康食品的购买；增加健康食品的购买；并改善患有2型糖尿病的AI的健康食品预算和烹饪技能，这是一个健康结果较差风险较高的人群。这项工作将有助于为资源有限环境中的未来健康促进努力提供信息。
本研究于2018年10月9日在ClinicalTrials.gov上注册，标识符为NCT03699709。
