Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep.
Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep.
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DOI：
10.1186/s12966-023-01509-y
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发表时间：
2023-09-12
影响因子：
8.7
通讯作者：
Scully, Mary F.
中科院分区：
文献类型：
--
作者：
Wagner, Julie A.;Bermudez-Millan, Angela;Buckley, Thomas E.;Buxton, Orfeu M.;Feinn, Richard S.;Kong, Sengly;Kuoch, Theanvy;Master, Lindsay;Scully, Mary F.
难民的心理压力很大，阻碍了改变生活方式的努力。我们以前曾报道，社区健康教育工作者（CHE）糖尿病预防干预降低HbA 1c和抑郁症状的美国裔难民抑郁症;本文报道了这些干预措施的健康行为结果。参与者年龄在35-75岁之间，讲高棉语，有糖尿病风险，并且符合研究标准，可能患有抑郁症，a）抗抑郁药物和/或B）长期升高的抑郁症状。参与者被随机分配到三种CHE干预措施中的一种：1）生活方式干预，称为吃，走，睡（EWS），2）EWS加药剂师/CHE团队的药物治疗管理（EWS + MTM），或3）社会服务（SS;对照）。通过7天的活动记录仪测量身体活动和睡眠。根据文化定制的食物频率问卷报告，营养以碳水化合物衡量。在基线、终点（12个月）和随访（15个月）时进行评估。n = 188名参与者中78%为女性，平均年龄55岁，一半家庭收入<20，000美元，模式教育为7.0年。接受EWS干预的两个治疗组中的个体显著增加了他们的糙米消耗量（p <0.001，Cohen's d = 0.76）和他们的中度至剧烈活动（p = 0.039，d = 0.32）。没有干预改变睡眠持续时间、时间、效率或入睡后的觉醒。在各组中，增加糙米摄入量，增加剧烈活动和减少总睡眠时间变异性的个体显示出HbA 1c降低，效应大小较小。CHE可以改善抑郁症难民的营养和身体活动，但可能需要更密集的干预措施来影响睡眠。所有三种行为的改善似乎与HbA 1c降低相关ClinicalTrials.gov标识符NCT 02502929。
Refugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions. Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months). The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal education was 7.0 years. Individuals in the two treatment groups that received the EWS intervention significantly increased their brown rice consumption (p < .001, Cohen’s d = 0.76) and their moderate-to-vigorous activity (p = .039, d = 0.32). No intervention changed sleep duration, timing, efficiency or wake after sleep onset. Across groups, individuals who increased brown rice consumption, increased vigorous activity and decreased total sleep time variability showed decreased HbA1c, with small effect sizes. CHEs may improve nutrition and physical activity in refugees with depression but more intensive interventions may be required to impact sleep. Improvements in all three behaviors appear to be associated with HbA1c lowering ClinicalTrials.gov identifier NCT02502929.
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影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
柬埔寨难民中的糖尿病和心血管疾病风险。
影响因子：
1.9
作者：
Marshall GN;Schell TL;Wong EC;Berthold SM;Hambarsoomian K;Elliott MN;Bardenheier BH;Gregg EW
通讯作者：
Gregg EW
影响因子：
16.2
作者：
Cappuccio FP;D'Elia L;Strazzullo P;Miller MA
通讯作者：
Miller MA
影响因子：
5
作者：
Matthews, Charles E.;Chen, Kong Y.;Troiano, Richard P.
通讯作者：
Troiano, Richard P.
影响因子：
2.2
作者：
Wagner J;Bermudez-Millan A;Buckley T;Buxton OM;Feinn R;Kong S;Kuoch T;Nahmod NG;Scully M
通讯作者：
Scully M