Misra Ranjita, Shawley-Brzoska Samantha
School of Public Health Professor, Department of Social & Behavioral Sciences, Robert C Byrd Health Science Center West Virginia University, Morgantown, WV, USA.
School of Public Health Research Assistant Professor, Department of Social & Behavioral Sciences, Robert C Byrd Health Science Center West Virginia University, Morgantown, WV, USA.
J Clin Transl Sci. 2024 Oct 29;8(1):e179. doi: 10.1017/cts.2024.623. eCollection 2024.
West Virginia is a rural state with high rates of type 2 diabetes (T2DM) and prediabetes. The Diabetes Prevention and Management (DPM) program was a health coach (HC)-led, 12-month community-based lifestyle intervention.
The study examined the impact of the DPM program on changes in glycosylated hemoglobin (A1C) and weight over twelve months among rural adults with diabetes and prediabetes. Program feasibility and acceptability were also explored.
An explanatory sequential quantitative and qualitative one-group study design was used to gain insight into the pre- and 12-month changes to health behavior and clinical outcomes. Trained HCs delivered the educational sessions and provided weekly health coaching feedback. Assessments included demographics, clinical, anthropometric, and qualitative focus groups. Participants included 94 obese adults with diabetes (63%) and prediabetes (37%). Twenty-two participated in three focus groups.
Average attendance was 13.7 ± 6.1 out of 22 sessions. Mean weight loss was 4.4 ± 11.5 lbs at twelve months and clinical improvement in A1C (0.4%) was noted among T2DM adults. Program retention (82%) was higher among older participants and those with poor glycemic control. While all participants connected to a trained HC, only 72% had regular weekly health coaching. Participants reported overall acceptability and satisfaction with the program and limited barriers to program engagement.
Our findings suggest that it is feasible to implement an HC-led DPM program in rural communities and improve A1C in T2DM adults. Trained HCs have the potential to be integrated with healthcare teams in rural regions of the United States.
西弗吉尼亚州是一个农村州，2型糖尿病（T2DM）和糖尿病前期的发病率很高。糖尿病预防与管理（DPM）项目是一项由健康教练（HC）主导、为期12个月的基于社区的生活方式干预项目。
本研究考察了DPM项目对患有糖尿病和糖尿病前期的农村成年人在12个月内糖化血红蛋白（A1C）变化和体重变化的影响。同时还探讨了项目的可行性和可接受性。
采用解释性序列定量和定性单组研究设计，以深入了解健康行为和临床结果在基线和12个月时的变化。经过培训的健康教练开展教育课程，并每周提供健康指导反馈。评估内容包括人口统计学、临床、人体测量学和定性焦点小组。参与者包括94名肥胖成年人，其中患有糖尿病的占63%，患有糖尿病前期的占37%。22人参加了三个焦点小组。
22节课程的平均出勤人数为13.7±6.1人。12个月时平均体重减轻4.4±11.5磅，T2DM成年人的A1C有临床改善（0.4%）。老年参与者和血糖控制不佳者的项目留存率（82%）更高。虽然所有参与者都与一名经过培训的健康教练取得了联系，但只有72%的人接受了定期的每周健康指导。参与者报告了对该项目的总体可接受性和满意度，以及参与项目的有限障碍。
我们的研究结果表明，在农村社区实施由健康教练主导的DPM项目并改善T2DM成年人的A1C是可行的。经过培训的健康教练有潜力与美国农村地区的医疗团队整合。
