行为健康干预的可行性和效果：一项社区卫生工作者实施的教育干预预防 2 型糖尿病西班牙裔患者心血管疾病及其并发症的试点研究。

Feasibility and Outcomes of Behavioral Health Intervention: A Pilot Study of a Community Health Worker-Administered Educational Intervention to Prevent Cardiovascular Disease and Its Complications among Hispanic Patients with Type-2 Diabetes.

机构信息

Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA.

Rural Health Office, University of Arizona, Tucson, AZ 85721, USA.

出版信息

Int J Environ Res Public Health. 2023 Oct 24;20(21):6968. doi: 10.3390/ijerph20216968.

DOI:10.3390/ijerph20216968

PMID:37947526

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10649125/

Abstract

BACKGROUND

Hispanics in the United States experience a greater burden of type-2 diabetes (T2D), with a prevalence rate (17%) more than twice that of non-Hispanic whites (8%). Cardiovascular disease (CVD) is the leading cause of death among people with T2D. A culturally appropriate behavioral health intervention that addresses healthy lifestyle promotion is an impactful approach for health systems with scarce medical resources and a high prevalence of chronic conditions, including obesity and high blood pressure, which increase the likelihood of CVD mortality among type-2 diabetics.

PURPOSE

To assess the feasibility and outcomes of a behavioral intervention to decrease CVD and complications in a Hispanic diabetic population.

METHODS

(MSD), a behavioral intervention effective in a Mexican population, consists of a 13-week intervention addressing CVD and T2D knowledge and risk reduction. It was implemented in a sample of Hispanic diabetic patients from two federally qualified health centers (FQHCs). Clinical and behavioral variables were measured at baseline, postintervention, and 1-year follow-up.

RESULTS

The feasibility of MSD was rated as successful by all FQHC staff and well-received by both staff and study participants, with positive remarks about the culturally relevant components of the intervention. The sample size was = 30 (baseline), = 23 (postintervention), and = 19 (1-year follow-up). Of note, quantitative results showed trending decreases in Hba1c (7.06; 6.80; 6.30), blood pressure (132/83; 126/80; 123/78), and total cholesterol (160; 159; 154).

CONCLUSION

MSD is a feasible intervention and can address the need to improve health outcomes among Hispanic patients with T2D.

摘要

背景

在美国，西班牙裔人群患 2 型糖尿病（T2D）的负担更重，其患病率（17%）是非西班牙裔白种人的两倍多（8%）。心血管疾病（CVD）是 T2D 患者死亡的主要原因。对于医疗资源匮乏且慢性病高发（包括肥胖和高血压）的卫生系统来说，实施一种针对健康生活方式促进的、文化上适宜的行为健康干预措施是一种有效的方法，因为这会增加 2 型糖尿病患者 CVD 死亡率的可能性。

目的

评估一种针对西班牙裔糖尿病患者的行为干预措施在降低 CVD 及并发症方面的可行性和效果。

方法

MSD 是一种针对墨西哥人群有效的行为干预措施，由一个针对 CVD 和 T2D 知识及风险降低的 13 周干预组成。它在来自两个联邦合格的健康中心（FQHC）的西班牙裔糖尿病患者样本中实施。在基线、干预后和 1 年随访时测量临床和行为变量。

结果

所有 FQHC 工作人员都将 MSD 的可行性评为成功，工作人员和研究参与者都对干预的文化相关内容给予了高度评价。样本量为 = 30（基线）， = 23（干预后）， = 19（1 年随访）。值得注意的是，定量结果显示 Hba1c（7.06；6.80；6.30）、血压（132/83；126/80；123/78）和总胆固醇（160；159；154）呈下降趋势。