长期随访生活方式干预对中年后期、农村居住的初级保健中的拉丁裔的影响。
Long-Term Follow-Up of a Lifestyle Intervention for Late-Midlife, Rural-Dwelling Latinos in Primary Care.
机构信息
Stacey L. Schepens Niemiec, PhD, OTR/L, is Associate Professor of Research, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
Cheryl L. P. Vigen, PhD, is Associate Professor of Research, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles.
出版信息
Am J Occup Ther. 2021 Mar-Apr;75(2):7502205020p1-7502205020p11. doi: 10.5014/ajot.2021.042861.
IMPORTANCE
Rural-dwelling Latinos are an underresourced population in need of accessible and effective wellness programs.
OBJECTIVE
To evaluate patients' long-term health-related outcomes after lifestyle intervention.
DESIGN
An uncontrolled pilot trial assessing change in health from pretreatment to long-term follow-up (12 mo after intervention completion, no contact) and from posttreatment to long-term follow-up.
SETTING
Rural, community-based primary care.
PARTICIPANTS
Latino and Hispanic safety-net primary care patients, ages 50 to 64 yr.
INTERVENTION
A culturally tailored, 4-mo lifestyle intervention co-led by occupational therapy practitioners and Latino community health workers that features telehealth and in-home sessions covering topics such as healthy eating and navigating health care.
OUTCOMES AND MEASURES
Self-reported and physiological outcomes: symptom-well-being (primary), stress, sleep disturbance, social satisfaction, physical activity, patient activation, blood pressure, and weight. Exit interviews addressed health experiences and intervention impact on participants' lives.
RESULTS
Participants (N = 27) demonstrated clinically significant pretreatment to long-term follow-up benefits in all symptom-well-being dimensions (Cohen's d ≥ 0.8, p ≤ .004), with additional gains from posttreatment to long-term follow-up (d ≥ 0.4, p ≤ .05). Significant improvements from pre- to posttreatment in systolic blood pressure, stress, and social role and activity satisfaction were maintained at long-term follow-up. No changes were observed in weight, physical activity, or diastolic blood pressure. Participants described the intervention's sustained positive effect on their wellness.
CONCLUSIONS AND RELEVANCE
A lifestyle intervention led by occupational therapy practitioners and community health workers in a primary care context has potential to achieve long-term health benefits in rural-dwelling, late-midlife Latinos.
WHAT THIS ARTICLE ADDS
This study reveals that rural, late-midlife Latinos showed long-lasting improvements in psychological and physical health after finishing a program that helped them make healthy lifestyle choices. This finding supports the unique contribution of occupational therapy in primary care settings.
重要性
居住在农村的拉丁裔是一个资源匮乏的人群，他们需要可及且有效的健康计划。
目的
评估生活方式干预后患者的长期健康相关结果。
设计
一项非对照性试点试验，评估从治疗前到长期随访（干预完成后 12 个月，无联系）以及从治疗后到长期随访的健康变化。
设置
农村社区初级保健。
参与者
50 至 64 岁的拉丁裔和西班牙裔安全网初级保健患者。
干预措施
一种文化上量身定制的、为期 4 个月的生活方式干预措施，由职业治疗从业者和拉丁裔社区卫生工作者共同领导，采用远程医疗和家庭会议，涵盖健康饮食和就医等主题。
结果和措施
自我报告和生理结果：症状-幸福感（主要）、压力、睡眠障碍、社会满意度、身体活动、患者激活、血压和体重。退出访谈涉及健康体验和干预对参与者生活的影响。
结果
参与者（N=27）在所有症状-幸福感维度上均表现出从治疗前到长期随访的显著临床获益（Cohen's d≥0.8，p≤0.004），从治疗后到长期随访的获益进一步增加（d≥0.4，p≤0.05）。从治疗前到治疗后，收缩压、压力和社会角色及活动满意度均有显著改善，并在长期随访中得到维持。体重、身体活动或舒张压没有变化。参与者描述了干预对他们健康的持续积极影响。
结论和相关性
在初级保健环境中，由职业治疗从业者和社区卫生工作者领导的生活方式干预措施有可能为农村地区、中老年拉丁裔人群实现长期健康益处。
这篇文章的重要性在于
研究表明，完成帮助他们选择健康生活方式的项目后，农村地区的中老年拉丁裔在心理和身体健康方面都有持久的改善。这一发现支持了职业治疗在初级保健环境中的独特贡献。
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