影响 2 型糖尿病预防生活方式干预项目连续参与随访评估的因素：Feel4Diabetes 研究。

Factors affecting continuous participation in follow-up evaluations during a lifestyle intervention programme for type 2 diabetes prevention: The Feel4Diabetes-study.

机构信息

Department of Business Administration, Gies College of Business, University of Illinois Urbana-Champaign, Champaign, Illinois, USA.

First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Diabetes Centre, Laiko General Hospital, Athens, Greece.

出版信息

Diabet Med. 2024 Aug;41(8):e15368. doi: 10.1111/dme.15368. Epub 2024 Jun 5.

DOI:10.1111/dme.15368

PMID:38837852

Abstract

AIMS

Community- and school-based lifestyle interventions are an efficient method of preventing type 2 diabetes in vulnerable populations. Many participants, however, fail to complete the necessary follow-ups. We investigated factors affecting the continuous participation in follow-up evaluations during the Feel4Diabetes-study, a multilevel intervention programme implemented across Europe.

METHODS

Socioeconomic, sociodemographic and clinical factors were assessed for 2702 participants within six participating countries: Bulgaria and Hungary (low-to-middle-income countries, LMIC), Belgium and Finland (high-income countries, HIC) and Greece and Spain (high-income countries under austerity measures, HICAM).

RESULTS

Statistically significant differences were detected with respect to sex, control group, education level, employment status, BMI and blood pressure measurements (systolic and diastolic blood pressure). Post hoc analysis revealed significant differences within socioeconomic regions. Higher levels of education were associated with significantly lower attrition in HIC (p < 0.05) and HICAM (p < 0.001), higher employment status was associated with lower attrition in HICAM (p < 0.001) and being female was associated with lower attrition in LMIC (p < 0.001). Surprisingly, the intervention group exhibited higher-than-expected attrition in HIC (p < 0.001) and HICAM (p = 0.003), and lower attrition in LMIC (p = 0.007). When tested together in the same multivariable predictive model, all sociodemographic and socioeconomic variables along with higher BMI retained their statistical significance, while systolic and diastolic blood pressure failed to remain significant.

CONCLUSIONS

Key socioeconomic and sociodemographic factors along with BMI play a significant role in determining continuous participation in follow-up evaluations during school- and community-based intervention programmes.

摘要

目的

基于社区和学校的生活方式干预是预防弱势群体 2 型糖尿病的有效方法。然而，许多参与者未能完成必要的随访。我们研究了在 Feel4Diabetes 研究中影响连续参与随访评估的因素，该研究是在欧洲实施的多层次干预计划。

方法

在六个参与国家/地区（保加利亚和匈牙利[中低收入国家，LMIC]、比利时和芬兰[高收入国家，HIC]以及希腊和西班牙[高收入国家在紧缩措施下，HICAM]）对 2702 名参与者评估了社会经济、社会人口统计学和临床因素。

结果

在性别、对照组、教育程度、就业状况、BMI 和血压测量（收缩压和舒张压）方面存在统计学显著差异。事后分析显示在社会经济区域内存在显著差异。较高的教育水平与 HIC（p<0.05）和 HICAM（p<0.001）的较低失访率显著相关，较高的就业状况与 HICAM 的较低失访率显著相关（p<0.001），而女性与 LMIC 的较低失访率显著相关（p<0.001）。令人惊讶的是，干预组在 HIC（p<0.001）和 HICAM（p=0.003）中的失访率高于预期，而在 LMIC 中的失访率较低（p=0.007）。当在同一多变量预测模型中一起测试时，所有社会人口统计学和社会经济变量以及较高的 BMI 仍然具有统计学意义，而收缩压和舒张压则未能保持显著。