Misra Ranjita, James Delores
School of Public Health, Department of Social & Behavioral Sciences, 3812B, Robert C Byrd Health Science Center, West Virginia University, Morgantown, WV26506-9190, USA.
Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, 1864 Stadium Road, Suite 5, PO Box 118210, Gainesville, FL32611-8210, USA.
Public Health Nutr. 2025 Mar 27;28(1):e73. doi: 10.1017/S1368980025000436.
The study examined the impact of the Diabetes Prevention and Management programme on dietary tracking, changes in dietary behaviour, glycosylated Hb (HbA1c) and weight loss over 6 months among rural adults with type 2 diabetes and prediabetes. The programme was a health coach (HC)-led, community-based lifestyle intervention.
The study used an explanatory sequential quantitative and qualitative design to gain insight on participant's dietary behaviour and macronutrient consumption as well as experience with food tracking. Five of the twenty-two educational sessions focussed on dietary education. Participants were taught strategies for healthy eating and dietary modification. Trained HC delivered the sessions and provided weekly feedback to food journals.
Obese adults with type 2 diabetes or prediabetes ( 94) participated in the programme and 56 (66 %) completed dietary tracking (optional) for 6 months. Twenty-two participated in three focus groups.
Fifty-nine percent consistently completed food journals. At 6 months, average diet self-efficacy and dietary intake improved, and average weight loss was 4·58 (sd 9·14) lbs. Factors associated with weight loss included attendance, consistent dietary tracking, higher HbA1c, diabetes status and energy intake (adjusted = 43·5 %; = 0·003). Focus group participants reported that the programme improved eating habits. The consistency of dietary tracking was cumbersome yet beneficial for making better choices and was key to being honest.
Participants who consistently tracked their diet improved dietary self-efficacy and intake over 6 months. This model has the potential to be reproduced in other rural regions of the United States.
本研究调查了糖尿病预防与管理项目对2型糖尿病和糖尿病前期农村成年人在6个月内饮食追踪、饮食行为变化、糖化血红蛋白（HbA1c）及体重减轻的影响。该项目是一项由健康教练（HC）主导的、基于社区的生活方式干预措施。
本研究采用解释性序列定量和定性设计，以深入了解参与者的饮食行为、常量营养素消费以及食物追踪体验。22次教育课程中有5次聚焦于饮食教育。向参与者传授了健康饮食和饮食调整策略。训练有素的健康教练授课并每周对食物日志提供反馈。
94名患有2型糖尿病或糖尿病前期的肥胖成年人参与了该项目，56名（66%）完成了为期6个月的饮食追踪（非强制性）。22名参与者参加了三个焦点小组。
59%的人持续完成了食物日志。6个月时，平均饮食自我效能感和饮食摄入量有所改善，平均体重减轻4.58（标准差9.14）磅。与体重减轻相关的因素包括出勤情况、持续的饮食追踪、较高的HbA1c、糖尿病状态和能量摄入（调整后R² = 43.5%；P = 0.003）。焦点小组参与者报告称该项目改善了饮食习惯。饮食追踪的持续性虽麻烦但有助于做出更好的选择，且是保持诚实的关键。
持续追踪饮食的参与者在6个月内改善了饮食自我效能感和摄入量。该模式有在美国其他农村地区推广的潜力。
