密歇根男性糖尿病项目（MenD）：同伴领导糖尿病自我管理教育和支持干预的方案。
Michigan Men's diabetes project (MenD): protocol for a peer leader diabetes self-management education and support intervention.
机构信息
University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA.
Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA.
出版信息
BMC Public Health. 2021 Mar 22;21(1):562. doi: 10.1186/s12889-021-10613-2.
BACKGROUND
Black men are more likely to be diagnosed with type 2 diabetes (T2D) compared to non-Hispanic White men, and this disparity increases among men over the age of 55. A growing body of literature demonstrates the critical role of gender in the management of health behaviors such as T2D and shows that male gender norms can conflict with healthy behaviors. These studies suggest that tailoring diabetes self-management interventions to address the needs of Black men may be critical to helping them to achieve optimal health outcomes. Further, our own research on Blacks with T2D found gender disparities in participation in diabetes interventions, with males participating at significantly lower rates than females. Peer leaders are trained lay individuals who are used to provide ongoing diabetes self-management support to people with diabetes, particularly in minority communities. However, despite studies showing that diabetes management interventions using peer leaders have been successful, the majority of peer leaders as well as the participants in those studies are women. The limited studies to date suggest that Black men with T2D prefer peer-led, male-to-male T2D programs, however, this research consists primarily of nonrandomized, small sample feasibility studies calling for additional studies to establish the efficacy of these approaches. The proposed study will develop and preliminarily validate the effectiveness of an adapted peer leader diabetes self-management support (PLDSMS) intervention designed to improve diabetes-related lifestyle and self-management behaviors in Black men (over 55) with T2D.
METHOD
We propose to tailor an existing intervention by 1) our using male peers and 2) modifying the peer leader training content to focus on material appropriate for men. The proposed study includes a developmental phase (development of the intervention with expert feedback, followed by feasibility testing with Black men) and a validation phase [randomized clinical trial (RCT)].
DISCUSSION
If successful, this study will lead to the development and dissemination of an intervention that will address the unique needs of Black men with T2D, helping them to achieve optimal diabetes self-management and health outcomes.
TRIAL REGISTRATION
Registered at ClinicalTrials.gov with an ID NCT04760444 on February 17, 2021.
背景
与非西班牙裔白人男性相比，黑人男性更有可能被诊断出患有 2 型糖尿病（T2D），而且这种差距在 55 岁以上的男性中会越来越大。越来越多的文献表明，性别在管理 T2D 等健康行为方面起着至关重要的作用，并表明男性性别规范可能与健康行为相冲突。这些研究表明，针对黑人男性的需求定制糖尿病自我管理干预措施可能对帮助他们实现最佳健康结果至关重要。此外，我们自己对 T2D 黑人患者的研究发现，在参与糖尿病干预方面存在性别差异，男性参与率明显低于女性。同伴领导者是经过培训的非专业人员，用于为糖尿病患者提供持续的糖尿病自我管理支持，特别是在少数族裔社区。然而，尽管有研究表明，使用同伴领导的糖尿病管理干预措施取得了成功，但大多数同伴领导人和这些研究的参与者都是女性。迄今为止，为数不多的研究表明，患有 T2D 的黑人男性更喜欢由同伴领导的男性对男性 T2D 项目，然而，这些研究主要是非随机的、小样本的可行性研究，呼吁开展更多研究以确定这些方法的有效性。拟议的研究将开发并初步验证一种经过改编的同伴领导糖尿病自我管理支持（PLDSMS）干预措施的有效性，该干预措施旨在改善患有 T2D 的 55 岁以上黑人男性的与糖尿病相关的生活方式和自我管理行为。
方法
我们建议通过以下方式调整现有干预措施：1）使用男性同伴，2）修改同伴领导培训内容，重点关注适合男性的内容。拟议的研究包括发展阶段（在获得专家反馈的情况下开发干预措施，然后对黑人男性进行可行性测试）和验证阶段[随机临床试验（RCT）]。
讨论
如果成功，这项研究将开发和传播一种干预措施，该措施将满足患有 T2D 的黑人男性的独特需求，帮助他们实现最佳的糖尿病自我管理和健康结果。
试验注册
于 2021 年 2 月 17 日在 ClinicalTrials.gov 注册，登记号为 NCT04760444。
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