Translating the Diabetes Prevention Program into American Indian and Alaska Native communities: results from the Special Diabetes Program for Indians Diabetes Prevention demonstration project.
Translating the Diabetes Prevention Program into American Indian and Alaska Native communities: results from the Special Diabetes Program for Indians Diabetes Prevention demonstration project.
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DOI：
10.2337/dc12-1250
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发表时间：
2013-07
期刊：
影响因子：
16.2
通讯作者：
Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
中科院分区：
文献类型：
--
作者：
Jiang L;Manson SM;Beals J;Henderson WG;Huang H;Acton KJ;Roubideaux Y;Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
具有里程碑意义的糖尿病预防计划（DPP）表明，生活方式干预可以预防或延迟风险人群的糖尿病发作。我们评估了这种干预在不同的美洲印第安人和阿拉斯加原住民（AI/AN）社区的翻译实施。印第安人糖尿病预防特别方案（SDPI-DP）示范项目在为80个部落服务的36个保健方案中实施了DPP生活方式干预。截至2008年7月31日，共招募了2，553名糖尿病前期参与者并开始干预。他们接受了16节的生活方式平衡课程，并在完成课程后不久（课程后）进行了全面的临床评估，以评估他们的糖尿病状态和基线风险，并每年进行长达3年的评估。估计糖尿病发病率。还评估了干预后的体重减轻，血压和血脂水平的变化以及生活方式的变化。SDPI-DP的完成率分别为74%，59%，42%和33%的课程后和第1年，第2年和第3年的评估。SDPI-DP参与者中糖尿病的粗发病率为每年4.0%。干预后立即观察到体重、血压和血脂水平的显著改善，此后每年观察3年。上课出勤率与糖尿病发病率、体重减轻和收缩压变化密切相关。我们的研究结果证明了在不同的AI/AN社区中翻译生活方式干预的可行性和潜力。它们对今后在整个美洲土著卫生系统中传播和制度化干预措施具有重要意义。
The landmark Diabetes Prevention Program (DPP) showed that lifestyle intervention can prevent or delay the onset of diabetes for those at risk. We evaluated a translational implementation of this intervention in a diverse set of American Indian and Alaska Native (AI/AN) communities. The Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented the DPP lifestyle intervention among 36 health care programs serving 80 tribes. A total of 2,553 participants with prediabetes were recruited and started intervention by 31 July 2008. They were offered the 16-session Lifestyle Balance Curriculum and underwent a thorough clinical assessment for evaluation of their diabetes status and risk at baseline, soon after completing the curriculum (postcurriculum), and annually for up to 3 years. Diabetes incidence was estimated. Weight loss, changes in blood pressure and lipid levels, and lifestyle changes after intervention were also evaluated. The completion rates of SDPI-DP were 74, 59, 42, and 33% for the postcurriculum and year 1, 2, and 3 assessments, respectively. The crude incidence of diabetes among SDPI-DP participants was 4.0% per year. Significant improvements in weight, blood pressure, and lipid levels were observed immediately after the intervention and annually thereafter for 3 years. Class attendance strongly correlated with diabetes incidence rate, weight loss, and change in systolic blood pressure. Our findings demonstrate the feasibility and potential of translating the lifestyle intervention in diverse AI/AN communities. They have important implications for future dissemination and institutionalization of the intervention throughout the Native American health system.