Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus, Ohio.
The Ohio State University College of Nursing, Columbus, Ohio.
J Acad Nutr Diet. 2023 Mar;123(3):492-503.e5. doi: 10.1016/j.jand.2022.07.020. Epub 2022 Aug 6.
Diabetes self-management education and support is the cornerstone of diabetes care, yet <10% of adults with diabetes manage their condition successfully. Feasible interventions are needed urgently.
Our aim was to assess the feasibility of a cooking intervention with food provision and diabetes self-management education and support.
This was a waitlist-controlled, randomized trial.
PARTICIPANTS/SETTING: Thirteen adults with type 1 or type 2 diabetes who participated in Cooking Matters for Diabetes (CMFD) participated in 2 focus groups.
CMFD was adapted from Cooking Matters and the American Diabetes Association's diabetes self-management education and support intervention into a 6-week program with weekly lesson-aligned food provisions.
Feasibility was evaluated quantitatively and qualitatively along the following 5 dimensions: demand, acceptability, implementation, practicality, and limited efficacy.
Two coders extracted focus group themes with 100% agreement after iterative analysis, resulting in consensus. Administrative data were analyzed via descriptive statistics.
Mean (SD) age of focus group participants was 57 (14) years; 85% identified as female; 39% identified as White; 46% identified as Black; and income ranged from <$5,000 per year (15%) to $100,000 or more per year (15%). Mean (SD) baseline hemoglobin A1c was 8.6% (1.2%). Mean attendance in CMFD was 5 of 6 classes (83%) among all participants. Demand was high based on attendance and reported intervention utilization and was highest among food insecure participants, who were more likely to report using the food provisions and recipes. Acceptability was also high; focus groups revealed the quality of instructors and interaction with peers as key intervention strengths. Participant ideas for implementation refinement included simplifying recipes, lengthening class sessions, and offering more food provision choices. Perceived effects of the intervention included lower hemoglobin A1c and body weight and improvements to health-related quality of life.
The CMFD intervention was feasible according to the measured principles of demand, acceptability, implementation, practicality, and limited efficacy.
糖尿病自我管理教育和支持是糖尿病护理的基石,但只有不到 10%的糖尿病患者能够成功地管理自己的病情。目前迫切需要可行的干预措施。
我们旨在评估提供食物和糖尿病自我管理教育及支持的烹饪干预措施的可行性。
这是一项等待期对照、随机试验。
参与者/设置:13 名患有 1 型或 2 型糖尿病的成年人参加了糖尿病烹饪课程(CMFD),他们参加了 2 次焦点小组。
CMFD 是从烹饪技巧和美国糖尿病协会的糖尿病自我管理教育及支持干预措施改编而来的,它是一个为期 6 周的项目,每周的课程都有与课程内容一致的食物供应。
通过以下 5 个维度评估可行性:需求、可接受性、实施、实用性和有限疗效。
两名编码员通过迭代分析,以 100%的一致性提取焦点小组主题,从而达成共识。对行政数据进行描述性统计分析。
焦点小组参与者的平均(SD)年龄为 57(14)岁;85%为女性;39%为白人;46%为黑人;收入范围从每年<5000 美元(15%)到 10 万美元或以上(15%)。平均(SD)基线糖化血红蛋白为 8.6%(1.2%)。所有参与者中,平均参加 CMFD 的课程为 6 次中的 5 次(83%)。基于出勤率和报告的干预措施利用率,需求较高,且在食物无保障的参与者中需求最高,他们更有可能报告使用食物供应和食谱。可接受性也很高;焦点小组揭示了教师的素质和与同伴的互动是关键的干预优势。参与者对实施细节的改进建议包括简化食谱、延长课程时间和提供更多食物供应选择。干预措施的预期效果包括糖化血红蛋白和体重降低,以及改善健康相关生活质量。
根据需求、可接受性、实施、实用性和有限疗效的原则,CMFD 干预措施是可行的。