Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program.
Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program.
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DOI：
10.1186/s13012-016-0426-2
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发表时间：
2016-05-18
期刊：
影响因子：
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通讯作者：
Rios C
中科院分区：
文献类型：
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作者：
Handley MA;Harleman E;Gonzalez-Mendez E;Stotland NE;Althavale P;Fisher L;Martinez D;Ko J;Sausjord I;Rios C
早发糖尿病的风险增长最快的群体之一是最近怀孕并患有妊娠期糖尿病的女性，对于这一群体来说，拉丁裔是美国最大的高危群体。尽管以循证为基础的干预措施，如糖尿病预防计划(DPP)，专注于饮食、体力活动和体重管理的低成本改变，可以降低糖尿病风险并推迟发病，但这些计划尚未针对产后拉丁裔妇女量身定做。这项研究的目的是量身定做一项IT支持的健康沟通计划，以促进最近患有妊娠糖尿病的拉丁裔妇女产后与DPP一致的行为改变。COM-B模型(包括能力、机会和动机行为障碍和使能者)和行为改变轮(BCW)框架传达了一种基于理论的干预开发方法。我们将为少数民族糖尿病患者量身定做的健康素养健康IT工具与基于BCW的方法相结合，开发了针对最近患有妊娠糖尿病的拉丁裔产后妇女的健康指导干预措施。目前的证据表明，四个焦点小组(n = 22名参与者)和一个由卫生保健提供者、糖尿病专家和健康素养从业者组成的地区联合会的投入为干预发展提供了信息。焦点群体数据的主题分析使用COM-B模型来确定内容。使用BCW框架选择了支撑干预设计和开发的相关文化、理论和技术组成部分。Star Mama使用健康传播战略用西班牙语和英语提供DPP内容，以：(1)验证产后妇女挣扎的情绪和经历；(2)通过母亲成为代际健康监护人，鼓励将预防战略纳入家庭生活；以及(3)通过转介社交网络、健康教练和社区资源，增加社会和物质支持。可行性、可接受性和与健康相关的结果(减肥、体力活动、健康食品消费、母乳喂养和葡萄糖筛查)将在产后9个月使用随机对照试验设计进行评估。Star Mama提供了基于DPP的干预，整合了基于理论的设计步骤。通过系统地使用行为理论来为干预发展提供信息，STAR MAMA可能代表了一种开发健康IT干预工具以满足不同人群需求的战略。ClinicalTrials.gov NCT02240420本文的在线版本(DOI：10.1186/s13012-016-0426-2)包含补充材料，授权用户可以使用。
One of the fastest growing risk groups for early onset of diabetes is women with a recent pregnancy complicated by gestational diabetes, and for this group, Latinas are the largest at-risk group in the USA. Although evidence-based interventions, such as the Diabetes Prevention Program (DPP), which focuses on low-cost changes in eating, physical activity and weight management can lower diabetes risk and delay onset, these programs have yet to be tailored to postpartum Latina women. This study aims to tailor a IT-enabled health communication program to promote DPP-concordant behavior change among postpartum Latina women with recent gestational diabetes. The COM-B model (incorporating Capability, Opportunity, and Motivational behavioral barriers and enablers) and the Behavior Change Wheel (BCW) framework, convey a theoretically based approach for intervention development. We combined a health literacy-tailored health IT tool for reaching ethnic minority patients with diabetes with a BCW-based approach to develop a health coaching intervention targeted to postpartum Latina women with recent gestational diabetes. Current evidence, four focus groups (n = 22 participants), and input from a Regional Consortium of health care providers, diabetes experts, and health literacy practitioners informed the intervention development. Thematic analysis of focus group data used the COM-B model to determine content. Relevant cultural, theoretical, and technological components that underpin the design and development of the intervention were selected using the BCW framework. STAR MAMA delivers DPP content in Spanish and English using health communication strategies to: (1) validate the emotions and experiences postpartum women struggle with; (2) encourage integration of prevention strategies into family life through mothers becoming intergenerational custodians of health; and (3) increase social and material supports through referral to social networks, health coaches, and community resources. Feasibility, acceptability, and health-related outcomes (weight loss, physical activity, consumption of healthy foods, breastfeeding, and glucose screening) will be evaluated at 9 months postpartum using a randomized controlled trial design. STAR MAMA provides a DPP-based intervention that integrates theory-based design steps. Through systematic use of behavioral theory to inform intervention development, STAR MAMA may represent a strategy to develop health IT intervention tools to meet the needs of diverse populations. ClinicalTrials.gov NCT02240420 The online version of this article (doi:10.1186/s13012-016-0426-2) contains supplementary material, which is available to authorized users.