Wilmoth Summer R, Carrillo-McCracken Leah L, Wilhite Bradley, Pan Meixia, Parra-Medina Deborah, Sosa Erica T, Reyes Ramon, He Meizi
Department of Public Health, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX 78249, USA.
Barshop Institute, UT Health Science Center (UT Health) San Antonio, San Antonio, TX 78229, USA.
Nutrients. 2024 Dec 28;17(1):69. doi: 10.3390/nu17010069.
This study aimed to adapt evidence-based diabetes self-management education and support (DSMES) into a faith-based (FB) context for Hispanic communities and compare its effectiveness to a faith-placed (FP) approach using the church as a venue for DSMES delivery. A cluster-randomized trial was conducted among adults with type 2 diabetes from predominantly Hispanic churches. The churches were assigned to either the FB Group (nine churches, n = 146) or the FP Group (seven churches, n = 125). The FB Group, led by trained lay health leaders, received a health sermon, a six-session DSMES program, and a seven-session Healthy Bible Study. The FP Group, led by outside health professionals, received the same six-session DSMES and a seven-session partial attention control curriculum. Key outcomes, including hemoglobin A1c (HbA1c), waist circumference (WC), diabetes distress, self-care activities, and self-efficacy, were assessed at baseline, 6, 9, and 12 months. The FB Group had lower HbA1c levels than the FP Group at 6 months (-0.3%, < 0.01), with no within-group differences post-intervention. No significant between-group differences were found for other outcomes. Within-group comparisons from baseline showed that both groups reduced WC at 9 and 12 months. Both groups showed reductions in diabetes distress and increased self-efficacy at all time points post-intervention ( < 0.05). The FB Group increased self-care scores at all time points post-intervention, while the FP Group increased at 9 and 12 months. DSMES can be effectively delivered in church settings by trained lay leaders or health professionals in Hispanic communities. Adding a spiritual dimension to DSMES may enhance outcomes.
本研究旨在将基于证据的糖尿病自我管理教育与支持（DSMES）调整为适合西班牙裔社区基于信仰（FB）的模式，并将其有效性与以教堂为DSMES实施场所的基于信仰场所（FP）的方法进行比较。在主要来自西班牙裔教堂的2型糖尿病成年患者中进行了一项整群随机试验。这些教堂被分配到FB组（9个教堂，n = 146）或FP组（7个教堂，n = 125）。FB组由经过培训的非专业健康领袖领导，接受一次健康布道、一个为期六节的DSMES项目和一个为期七节的健康圣经学习。FP组由外部健康专业人员领导，接受相同的为期六节的DSMES和一个为期七节的部分注意力控制课程。在基线、6个月、9个月和12个月时评估关键结果，包括糖化血红蛋白（HbA1c）、腰围（WC）、糖尿病困扰、自我护理活动和自我效能感。FB组在6个月时的HbA1c水平低于FP组（-0.3%，P < 0.01），干预后组内无差异。其他结果在组间未发现显著差异。与基线的组内比较显示，两组在9个月和12个月时WC均降低。两组在干预后的所有时间点糖尿病困扰均降低，自我效能感均增加（P < 0.05）。FB组在干预后的所有时间点自我护理得分均增加，而FP组在9个月和12个月时增加。经过培训的非专业领袖或健康专业人员可以在西班牙裔社区的教堂环境中有效实施DSMES。在DSMES中增加精神层面可能会改善结果。
