Nonmedical Interventions For Type 2 Diabetes: Evidence, Actionable Strategies, And Policy Opportunities.
Nonmedical Interventions For Type 2 Diabetes: Evidence, Actionable Strategies, And Policy Opportunities.
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DOI：
10.1377/hlthaff.2022.00236
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发表时间：
2022-07
期刊：
影响因子：
9.7
通讯作者：
Ozieh, Mukoso N.
中科院分区：
文献类型：
--
作者：
Egede, Leonard E.;Walker, Rebekah J.;Linde, Sebastian;Campbell, Jennifer A.;Dawson, Aprill Z.;Williams, Joni S.;Ozieh, Mukoso N.
这项系统综述确定了旨在降低 2 型糖尿病风险并改善临床结果的非医疗干预研究。具体来说，本次审查旨在确定针对结构性种族主义和健康问题社会决定因素的干预措施。纳入其中的研究以英文发表；在数据库启动至 2022 年 1 月之间发布；在美国进行；使用临床试验、准实验或事前设计来测量干预效果；包括有 2 型糖尿病风险或患有 2 型糖尿病的成年人群；以及目标糖化血红蛋白水平、血压、血脂、自我护理或生活质量作为结果。我们的综述结果表明，结合医学和非医学方法的有针对性的多成分设计干预措施可以降低 2 型糖尿病的风险并改善临床结果。通过使用食品补充剂以及转诊和糖尿病支持，HbA1c 水平显着改善；利用财政激励措施进行教育和技能培训；使用住房搬迁并提供咨询支持；以及使用电子病历将非医疗干预措施整合到医疗保健中。我们的研究结果表明，旨在解决相关社会因素和针对结构性种族主义的非医疗干预措施的文献有限。本文提供了可行的策略，并确定了针对结构性不平等和降低 2 型糖尿病成人社会风险的政策机会。
This systematic review identified studies of nonmedical interventions designed to reduce risk for and improve clinical outcomes for type 2 diabetes. Specifically, this review sought to identify interventions that target structural racism and social determinants of health. To be included, studies were published in English; published between database initiation and January 2022; conducted in the United States; measured an intervention effect using a clinical trial, quasi-experimental, or pre-post design; included a population of adults at risk for or with type 2 diabetes; and targeted hemoglobin A1c levels, blood pressure, lipids, self-care, or quality of life as outcomes. The findings of our review indicate that interventions with targeted, multicomponent designs that combine both medical and nonmedical approaches can reduce risk for and improve clinical outcomes for type 2 diabetes. HbA1c levels improved significantly with the use of food supplementation with referral and diabetes support; the use of financial incentives with education and skills training; the use of housing relocation with counseling support; and the integration of nonmedical interventions into medical care using the electronic medical record. Our findings demonstrate that the literature on nonmedical interventions designed to address relevant social factors and target structural racism is limited. The article offers actionable strategies and identifies policy opportunities for targeting structural inequalities and decreasing social risk among adults with type 2 diabetes.
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结构性种族主义，社会危险因素和共同-19-对黑人美国人的危险融合。
DOI：
10.1056/nejmp2023616
发表时间：
2020-09-17
期刊：
The New England journal of medicine
影响因子：
--
作者：
Egede LE;Walker RJ
通讯作者：
Walker RJ
影响因子：
9.7
作者：
Bai, Ge;Anderson, Gerard F.
通讯作者：
Anderson, Gerard F.
影响因子：
5.9
作者：
Himmelstein, David U.;Thorne, Deborah;Woolhandler, Steffie
通讯作者：
Woolhandler, Steffie
影响因子：
3.8
作者：
Okemah J;Peng J;Quiñones M
通讯作者：
Quiñones M
影响因子：
4.4
作者：
Lenhart, Otto
通讯作者：
Lenhart, Otto