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为提高黑人和拉丁裔男性参与度量身定制的虚拟糖尿病预防计划:一项随机对照试验的方案

Virtual Diabetes Prevention Program Tailored to Increase Participation of Black and Latino Men: Protocol for a Randomized Controlled Trial.

作者信息

Chambers Earle C, Walker Elizabeth A, Schechter Clyde, Gil Eric, Herbert Terysia, Diaz Katelyn, Gonzalez Jeffrey

机构信息

Albert Einstein College of Medicine, Bronx, NY, United States.

Yeshiva University, Bronx, NY, United States.

出版信息

JMIR Res Protoc. 2025 Jun 24;14:e64405. doi: 10.2196/64405.


DOI:10.2196/64405
PMID:40554781
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12238785/
Abstract

BACKGROUND: Black and Latino men are at increased risk for poor diabetes health outcomes but are underrepresented in lifestyle interventions for weight loss and diabetes prevention. Although relatively few men participate in the National Diabetes Prevention Program (NDPP), it remains the most widely available evidence-based approach to type 2 diabetes prevention in the United States. Thus, an NDPP tailored to Black and Latino men has the potential to address prior limitations of NDPP implementation and reduce gender, racial, and ethnic diabetes disparities. It also provides an opportunity to define a population for targeted outreach and evaluate the reach of our recruitment methods and interventions. OBJECTIVE: We tailored the US Centers for Disease Control and Prevention Prevent T2 curriculum for the NDPP for Black and Latino men, called Power-Up, and will evaluate its effects in comparison to standard mixed-gender NDPP groups via virtual delivery. The primary aim of the project is to assess the effect of Power-Up versus NDPP on weight loss among men with prediabetes. The secondary aim is to compare the engagement and retention of men with prediabetes in Power-Up versus NDPP. We will also examine the reach of our recruitment methods and engagement in our screening, consenting, and assessment procedures prior to the point of randomization. We hypothesized that men randomized to Power-Up would achieve greater percent weight loss from baseline at 16 weeks (end of Core sessions) and 1 year (end of Maintenance sessions) than men randomized to standard, mixed-gender NDPP. Power-Up is also expected to have better engagement and retention. METHODS: Using the electronic health record (EHR) systems of a large academic medical center and a network of small to medium independent primary care practices throughout New York City, we identified Black and Latino men who met eligibility criteria for NDPP and enrolled them in a randomized controlled trial in which they were assigned 1:1 to receive Power-Up or the standard, mixed-gender NDPP over 1 year via online videoconferencing. Coaches delivering these interventions were trained according to the standards for the NDPP. Power-Up will be delivered by men coaches. Weight will be collected with home-based electronic scales for primary outcome analyses. Engagement will be assessed by session attendance logs. RESULTS: We identified 11,052 men for outreach based on EHR data, successfully screened 26% of them, consented and enrolled 22% of these, and randomly assigned 48% of consented participants. Primary and secondary outcome analyses will be assessed among randomized men. CONCLUSIONS: This study highlights the effort required to reach and engage Black and Latino men for virtually delivered diabetes prevention programs. Forthcoming trial results for weight loss and engagement will further inform efforts to address disparities in diabetes prevention through tailored programming for Black and Latino men. TRIAL REGISTRATION: ClinicalTrials.gov NCT04104243; https://clinicaltrials.gov/study/NCT04104243. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/64405.

摘要

背景:黑人男性和拉丁裔男性患糖尿病后健康状况较差的风险更高,但在减肥和糖尿病预防的生活方式干预中所占比例较低。尽管参与国家糖尿病预防计划(NDPP)的男性相对较少,但它仍然是美国预防2型糖尿病最广泛可用的循证方法。因此,针对黑人男性和拉丁裔男性量身定制的NDPP有潜力解决NDPP实施过程中先前存在的局限性,并减少性别、种族和族裔之间的糖尿病差异。它还提供了一个机会,来确定一个目标人群,并评估我们招募方法和干预措施的覆盖范围。 目的:我们为黑人男性和拉丁裔男性的NDPP量身定制了美国疾病控制与预防中心的预防2型糖尿病课程,即“动力提升”课程,并将通过虚拟授课的方式,与标准的男女混合NDPP组比较评估其效果。该项目的主要目的是评估“动力提升”课程与NDPP对糖尿病前期男性体重减轻的影响。次要目的是比较糖尿病前期男性在“动力提升”课程与NDPP中的参与度和留存率。我们还将在随机分组前,检查我们招募方法的覆盖范围以及在筛查、同意参与和评估程序中的参与情况。我们假设,随机分配到“动力提升”课程组的男性在16周(核心课程结束时)和1年(维持课程结束时)时,相对于随机分配到标准男女混合NDPP组的男性,从基线开始的体重减轻百分比更高。预计“动力提升”课程也会有更好的参与度和留存率。 方法:利用一家大型学术医疗中心的电子健康记录(EHR)系统以及纽约市中小型独立初级保健机构网络,我们确定了符合NDPP资格标准的黑人男性和拉丁裔男性,并让他们参加一项随机对照试验,在试验中他们被1:1分配,通过在线视频会议在1年内接受“动力提升”课程或标准的男女混合NDPP。提供这些干预措施的教练按照NDPP的标准进行培训。“动力提升”课程将由男性教练授课。将使用家用电子秤收集体重数据,用于主要结局分析。参与度将通过课程出勤记录进行评估。 结果:根据EHR数据,我们确定了11052名男性进行推广,成功筛查了其中的26%,这些人中22%同意参与并登记,同意参与的参与者中有48%被随机分组。将在随机分组的男性中进行主要和次要结局分析。 结论:这项研究凸显了让黑人男性和拉丁裔男性参与虚拟糖尿病预防项目所需付出的努力。即将得出的关于体重减轻和参与度的试验结果,将为通过为黑人男性和拉丁裔男性量身定制项目来解决糖尿病预防差异的努力提供进一步信息。 试验注册:ClinicalTrials.gov NCT04104243;https://clinicaltrials.gov/study/NCT04104243。 国际注册报告识别码(IRRID):DERR1-10.2196/64405。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4164/12238785/29da6b3403f9/resprot_v14i1e64405_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4164/12238785/3712c508695d/resprot_v14i1e64405_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4164/12238785/29da6b3403f9/resprot_v14i1e64405_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4164/12238785/3712c508695d/resprot_v14i1e64405_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4164/12238785/29da6b3403f9/resprot_v14i1e64405_fig2.jpg

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[1]
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[2]
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Lancet. 2023-7-15

[4]
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