The University of Arizona, Tucson, AZ, USA.
El Rio Community Health Center, Tucson, AZ, USA.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211057643. doi: 10.1177/21501327211057643.
Maternal obesity and gestational diabetes mellitus (GDM) contribute to increased risk for type 2 diabetes mellitus (T2DM) among both mothers and their offspring. Randomized trials demonstrated T2DM risk reduction in adults following lifestyle behavior change and modest weight loss; the evidence base for at-risk children remains limited.
Evaluate the feasibility, acceptability, and preliminary efficacy of a T2DM prevention intervention for mother-child dyads delivered by Federally Qualified Health Center staff.
A group randomized design tested the effects of a behavioral lifestyle intervention on T2DM risk factors in women with a history of GDM and their 8- to 12-year-old children. Mother-child dyads were recruited and randomized to intervention or wait-listed control conditions. Intervention participants completed the 13-week intervention; control participants received standard of care. Baseline and 13-week measures assessed program acceptability and feasibility, and explored effects on body weight, waist circumference, hemoglobin A1c, and lifestyle behaviors.
Forty-two dyads were randomized and 35 (83%) completed pre-/post-measurements. Participants and program leaders positively rated content and engagement. Nearly all strongly agreed that activities were enjoyable (97%), applicable (96%), useful (97%), and motivational (96%). Attendance averaged 65% across 2 cohorts; delivery costs were approximately $225/dyad. There were no significant differences in body weight, BMI (or BMI -score), waist circumference, hemoglobin A1c, diet quality, physical activity, sleep, or home environment changes between intervention and control groups.
A family T2DM prevention program was feasibly delivered by FQHC staff, and acceptable to mothers and children. Program efficacy will be evaluated in an adequately powered clinical trial.
母亲肥胖和妊娠糖尿病（GDM）会增加母亲及其后代患 2 型糖尿病（T2DM）的风险。随机试验表明，通过生活方式行为改变和适度减重，可以降低成年人患 T2DM 的风险；而高危儿童的证据基础仍然有限。
评估由合格的联邦健康中心工作人员为母婴二人组提供的 T2DM 预防干预措施的可行性、可接受性和初步疗效。
采用群组随机设计，测试了针对有 GDM 病史的女性及其 8-12 岁子女的行为生活方式干预对 T2DM 危险因素的影响。招募母婴二人组并随机分为干预组或候补对照组。干预组完成了 13 周的干预；对照组则接受标准护理。基线和 13 周的测量评估了计划的可接受性和可行性，并探讨了对体重、腰围、血红蛋白 A1c 和生活方式行为的影响。
42 对母婴二人组被随机分配，其中 35 对（83%）完成了预/后测。参与者和项目负责人对内容和参与度给予了积极评价。几乎所有人都强烈认为活动有趣（97%）、适用（96%）、有用（97%）且有激励性（96%）。两个队列的出勤率平均为 65%；每个母婴二人组的交付成本约为 225 美元。干预组和对照组在体重、BMI（或 BMI 评分）、腰围、血红蛋白 A1c、饮食质量、身体活动、睡眠或家庭环境变化方面均无显著差异。
由合格的联邦健康中心工作人员提供的家庭 T2DM 预防计划是可行的，且母亲和儿童都能接受。该计划的疗效将在一项充分有力的临床试验中进行评估。
