老年人利用社会支持提高自我护理能力（OASIS）：阿巴拉契亚地区 2 型糖尿病老年患者同伴支持的改编、实施和可行性：一项可行性研究方案。

Older adults using social support to improve self-care (OASIS): Adaptation, implementation and feasibility of peer support for older adults with T2D in appalachia: A feasibility study protocol.

机构信息

Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America.

Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States of America.

出版信息

PLoS One. 2024 Mar 18;19(3):e0300196. doi: 10.1371/journal.pone.0300196. eCollection 2024.

DOI:10.1371/journal.pone.0300196

PMID:38498512

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10947915/

Abstract

INTRODUCTION

The prevalence of type 2 diabetes (T2D) is 17% higher in rural dwellers compared to their urban counterparts, and it increases with age, with an estimated 25% of older adults (≥ 65 years) diagnosed. Appropriate self-care is necessary for optimal clinical outcomes. Overall, T2D self-care is consistently poor among the general population but is even worse in rural-dwellers and older adults. In rural Kentucky, up to 23% of adults in Appalachian communities have been diagnosed with T2D and, of those, 26.8% are older adults. To attain optimal clinical outcomes, social environmental factors, including social support, are vital when promoting T2D self-care. Specifically, peer support has shown to be efficacious in improving T2D self-care behaviors and clinical and psychosocial outcomes related to T2D; however, literature also suggests self-selected social support can be obstructive when engaging in healthful activities. Currently available evidence-based interventions (EBIs) using peer support have not been used to prioritize older adults, especially those living in rural communities.

METHOD

To address this gap, we conducted formative research with stakeholders, and collaboratively identified an acceptable and feasible peer support EBI-peer health coaching (PHC)-that has resulted in improved clinical and psychosocial T2D-related outcomes among participants who did not reside in rural communities nor were ≥65 years. The goal of the proposed study is to use a 2x2 factorial design to test the adapted PHC components and determine their preliminary effectiveness to promote self-care behaviors and improve glycemic control among older adults living in Appalachian Kentucky. Testing the PHC components of the peer support intervention will be instrumental in promoting care for older adults in Appalachia, as it will allow for a larger scale intervention, which if effective, could be disseminated to community partners in Appalachia.

TRIAL REGISTRATION

This study was registered at www.clinicaltrials.gov (NCT06003634) in August 2023.

摘要

简介

与城市居民相比，农村居民 2 型糖尿病（T2D）的患病率高 17%，且随着年龄的增长而增加，估计有 25%的老年人（≥65 岁）被诊断出患有 T2D。适当的自我护理对于获得最佳临床结果至关重要。总的来说，T2D 的自我护理在一般人群中一直很差，但在农村居民和老年人中更差。在肯塔基州的农村地区，阿巴拉契亚社区中高达 23%的成年人被诊断出患有 T2D，其中 26.8%是老年人。为了获得最佳的临床结果，社会环境因素，包括社会支持，在促进 T2D 的自我护理中至关重要。具体来说，同伴支持已被证明在改善 T2D 自我护理行为以及与 T2D 相关的临床和心理社会结果方面是有效的；然而，文献还表明，当参与健康活动时，自我选择的社会支持可能会产生障碍。目前尚未使用基于证据的同伴支持干预措施（EBIs）来优先考虑老年人，尤其是那些居住在农村社区的老年人。

方法

为了解决这一差距，我们与利益相关者进行了形成性研究，并共同确定了一种可接受且可行的同伴支持 EBI-同伴健康教练（PHC），该方法已导致居住在农村社区或年龄≥65 岁的参与者的 T2D 相关临床和心理社会结果得到改善。拟议研究的目标是使用 2x2 析因设计来测试经改编的 PHC 组件，并确定它们促进自我护理行为和改善肯塔基州阿巴拉契亚地区老年人血糖控制的初步有效性。测试同伴支持干预措施的 PHC 组件对于促进阿巴拉契亚地区老年人的护理至关重要，因为这将允许进行更大规模的干预，如果有效，该干预可以传播给阿巴拉契亚地区的社区合作伙伴。