Herman W H, Thompson T J, Visscher W, Aubert R E, Engelgau M M, Liburd L, Watson D J, Hartwell T
Program Development Branches, National Center for Chronic Disease Prevention and Health Promotion, Center for Disease Control and Prevention, Atlanta, Georgia, USA.
J Natl Med Assoc. 1998 Mar;90(3):147-56.
Project DIRECT (Diabetes Intervention Reaching and Educating Communities Together) is a multilevel community-based intervention project designed to address diabetes and its complications in an African-American community. This article presents results of the Project DIRECT pilot study and describes risk factors for diabetes, diabetes prevalence, complications, and care practices. During 1993, a pilot study was conducted among persons 20 to 74 years of age in Wake County, North Carolina. The study involved household interviews and examinations, and more extensive health center interviews and examinations based on the race of the head of the household, previous diagnosis of diabetes, and results of capillary glucose tests done in the household. Of the black population aged 20 to 74 years, 52 +/- 3% reported being inactive and 51 +/- 3% were overweight; the prevalence of diagnosed diabetes was 5.2 +/- 0.9%; the prevalence of undiagnosed diabetes was 5.7 +/- 2.7%; and the prevalence of impaired glucose tolerance was 11.4 +/- 7.5%. Blacks with diabetes were significantly more likely than nonblacks with diabetes to have uncontrolled hypertension and to smoke cigarettes. Blacks with diabetes were significantly less likely to report having health insurance or to have a private health-care provider. Diabetes mellitus is a major public health problem in the African-American community of Wake County. Modifiable risk factors for diabetes and undiagnosed diabetes are common. Project DIRECT is attempting to improve the health-related quality of life of this population by reducing the burden of diabetes and its complications through a multilevel, community-based intervention.
“携手干预与教育社区糖尿病项目”（DIRECT项目）是一个基于社区的多层次干预项目，旨在解决非裔美国人社区中的糖尿病及其并发症问题。本文介绍了DIRECT项目试点研究的结果，并描述了糖尿病的风险因素、糖尿病患病率、并发症及护理情况。1993年，在北卡罗来纳州韦克县对20至74岁的人群进行了一项试点研究。该研究包括入户访谈和检查，以及根据户主种族、既往糖尿病诊断情况和家庭中进行的毛细血管血糖检测结果进行的更广泛的健康中心访谈和检查。在20至74岁的黑人人群中，52±3%的人报告不活动，51±3%的人体重超重；已诊断糖尿病的患病率为5.2±0.9%；未诊断糖尿病的患病率为5.7±2.7%；糖耐量受损的患病率为11.4±7.5%。患有糖尿病的黑人比患有糖尿病的非黑人更有可能出现未控制的高血压和吸烟。患有糖尿病的黑人报告有医疗保险或有私人医疗服务提供者的可能性显著降低。糖尿病是韦克县非裔美国人社区的一个主要公共卫生问题。糖尿病和未诊断糖尿病的可改变风险因素很常见。DIRECT项目正试图通过多层次的社区干预减轻糖尿病及其并发症的负担，从而改善该人群与健康相关的生活质量。
