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基于文化和语境的糖尿病培训对原住民初级保健提供者的影响:原住民客户结局的一项群组随机交叉试验的有效性研究方案。

Translation of culturally and contextually informed diabetes training for Aboriginal primary health care providers on Aboriginal client outcomes: Protocol of a cluster randomized crossover trial of effectiveness.

机构信息

Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.

Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.

出版信息

PLoS One. 2024 Jul 23;19(7):e0305472. doi: 10.1371/journal.pone.0305472. eCollection 2024.

DOI:10.1371/journal.pone.0305472
PMID:39042661
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11265707/
Abstract

BACKGROUND

Indigenous populations globally have significantly high rates of type 2 diabetes compared to their non-Indigenous counterparts. This study aims to implement and evaluate the effectiveness of a culturally and contextually informed Aboriginal Diabetes Workforce Training Program on Aboriginal primary health care workforce knowledge, attitude, confidence, skill and practice relating to diabetes care.

METHODS

A Cluster Randomised Crossover Control Trial with two arms (Group A and Group B) will be conducted with Aboriginal primary health care services in South Australia. These services primarily provide primary health care to Aboriginal and Torres Strait Islander people. All healthcare service sites will be randomised into groups A and B to receive the training program. The training program consists of three components: 1) Peer support network, 2) E-Learning modules and 3) onsite support. Aboriginal Health Workers of participating sites will be invited to participate in the monthly online peer support network and all chronic disease staff are eligible to participate in the E-Learning modules and onsite support. The Peer Support Network runs for the entirety of the study, 17 months. Training components 2 and 3 occur simultaneously and are 2.5 months in length, with a six-month washout period between the two randomised groups undertaking the training. All primary outcomes of the study relate to diabetes management in a primary health care settings and measure participants' knowledge, attitude, confidence, practice and skills. These will be collected at seven time points across the entire study. Secondary outcomes measure satisfaction of the peer support network using a survey, interviews to understand enablers and barriers to participation, health service systems characteristics through focus groups, and medical record review to ascertain diabetes patients' care received and their clinical outcomes up to 12 months post training intervention.

DISCUSSION

The findings will explore the effectiveness of the training program on Aboriginal primary health care provider knowledge, attitude, confidence, skill and practice relating to diabetes care. The final findings will be published in 2027.

TRIAL REGISTRATION

The study was prospectively registered in The Australian New Zealand Clinical Trials Registry (ANZCTR), with registration number ACTRN12623000749606 at ANZCTR - Registration. Universal Trial Number (UTN) U1111-1283-5257.

摘要

背景

与非土著人群相比,全球土著人群的 2 型糖尿病发病率显著更高。本研究旨在实施并评估一项具有文化和背景相关性的土著糖尿病劳动力培训计划对土著初级保健劳动力在糖尿病护理方面的知识、态度、信心、技能和实践的有效性。

方法

本研究将采用两组(A 组和 B 组)进行群组随机交叉对照试验,对象为南澳大利亚的土著初级保健服务。这些服务主要为澳大利亚原住民和托雷斯海峡岛民提供初级保健。所有医疗服务站点将随机分为 A 组和 B 组,以接受培训计划。培训计划包括三个部分:1)同伴支持网络,2)电子学习模块,3)现场支持。参与站点的土著卫生工作者将受邀参加每月的在线同伴支持网络,所有慢性病工作人员都有资格参加电子学习模块和现场支持。同伴支持网络在整个研究期间(17 个月)运行。培训组件 2 和 3同时进行,持续 2.5 个月,两个随机组之间有 6 个月的洗脱期,然后再进行培训。本研究的所有主要结果均与初级保健环境中的糖尿病管理相关,衡量参与者在知识、态度、信心、实践和技能方面的情况。这些结果将在整个研究过程中的 7 个时间点进行收集。次要结果通过调查衡量同伴支持网络的满意度,通过访谈了解参与的促进因素和障碍,通过焦点小组了解卫生服务系统的特点,以及通过医疗记录审查确定接受糖尿病患者护理及其临床结果在培训干预后 12 个月内的情况。

讨论

研究结果将探讨培训计划对土著初级保健提供者在糖尿病护理方面的知识、态度、信心、技能和实践的有效性。最终结果将于 2027 年公布。

试验注册

该研究前瞻性地在澳大利亚和新西兰临床试验注册中心(ANZCTR)注册,注册号为 ACTRN12623000749606,在 ANZCTR-Registration 注册。通用试验编号(UTN)U1111-1283-5257。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f4/11265707/82734a64ba67/pone.0305472.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f4/11265707/82734a64ba67/pone.0305472.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62f4/11265707/82734a64ba67/pone.0305472.g001.jpg

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