Joachim-Célestin Maud, Montgomery Susanne B
Department of Interdisciplinary Studies, School of Behavioral Health, Loma Linda University,Loma Linda, CA, USA.
Clin Med Insights Endocrinol Diabetes. 2024 Sep 14;17:11795514241274696. doi: 10.1177/11795514241274696. eCollection 2024.
BACKGROUND/OBJECTIVES: In the USA, diabetes disproportionately affects Hispanics/Latinx, continuing to contribute to health disparities. To address the diabetes epidemic, separate programs for pre-diabetes and diabetes are promoted nationwide. However, engagement by Hispanics/Latinx in either program is lagging. Recent evidence suggests that offering a single community health worker delivered intervention that includes both groups and allows family members to participate may be more effective and in harmony with Latino cultural values, especially if offered to Latino women (Latinas) who traditionally are in charge of food preparation. Our objective was to explore the results of an intervention delivered to low-income Latinas at various dysglycemic levels (diabetic and pre-diabetic).
In this quasi-experimental mixed-methods cohort study we longitudinally assessed biometric outcomes and health behaviors among obese Latinas at risk for-and with-diabetes, participating in the same intervention. Data were collected at baseline and 3 months post-intervention. Focus group discussions and interviews provided qualitative data to help contextualize findings.
Participants at different levels of the dysglycemic spectrum benefited equally from the intervention across most measures. Among participants whose relatives had diabetes, weight loss exceeded that of participants without diagnosed relatives. Domestic partners' support, attending the program in a group setting, and previous diagnoses from a healthcare professional were associated with better results.
Our findings indicate that a community health worker-delivered intervention for Hispanics/Latinx with-and at-risk for-diabetes is feasible and could be more effective in reducing Hispanics/Latinx' diabetes burden. Health educators and clinicians should consider tapping into the collective nature of the Latinx/Hispanic culture to encourage healthy behaviors among individuals whose family members have diabetes, regardless of their dysglycemic status. We recommend replicating this study with a more rigorous randomized design, a larger number of participants and longer-term follow-up.
背景/目的:在美国,糖尿病对西班牙裔/拉丁裔的影响尤为严重,持续加剧健康差距。为应对糖尿病流行问题,全国推行了针对糖尿病前期和糖尿病的单独项目。然而,西班牙裔/拉丁裔参与这两个项目的情况都很滞后。最近的证据表明,提供由社区卫生工作者实施的单一干预措施,该措施涵盖这两个群体并允许家庭成员参与,可能更有效且符合拉丁裔文化价值观,特别是如果提供给传统上负责食物准备的拉丁裔女性(拉丁美洲女性)。我们的目的是探讨对不同血糖异常水平(糖尿病和糖尿病前期)的低收入拉丁美洲女性实施干预的结果。
在这项准实验性混合方法队列研究中,我们纵向评估了参与同一干预措施的有糖尿病风险及患有糖尿病的肥胖拉丁美洲女性的生物特征结果和健康行为。在基线和干预后3个月收集数据。焦点小组讨论和访谈提供了定性数据,以帮助阐释研究结果。
在大多数指标上,处于不同血糖异常谱水平的参与者从干预中获得的益处相同。在亲属患有糖尿病的参与者中,体重减轻超过了亲属未被诊断患有糖尿病的参与者。伴侣的支持、以小组形式参加项目以及之前由医疗保健专业人员做出的诊断与更好的结果相关。
我们的研究结果表明,由社区卫生工作者对患有糖尿病及有糖尿病风险的西班牙裔/拉丁裔实施干预是可行的,并且在减轻西班牙裔/拉丁裔的糖尿病负担方面可能更有效。健康教育工作者和临床医生应考虑利用拉丁裔/西班牙裔文化的集体性质,鼓励家庭成员患有糖尿病的个体养成健康行为,无论其血糖异常状况如何。我们建议采用更严格的随机设计、更多的参与者和更长时间的随访来重复这项研究。