A Randomized Trial of a Church-Based Diabetes Self-management Program for African Americans With Type 2 Diabetes
A Randomized Trial of a Church-Based Diabetes Self-management Program for African Americans With Type 2 Diabetes
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DOI：
10.1177/0145721709333270
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发表时间：
2009-05-01
影响因子：
3.9
通讯作者：
Bangdiwala, Shrikant I.
中科院分区：
文献类型：
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作者：
Samuel-Hodge, Carmen D.;Keyserling, Thomas C.;Bangdiwala, Shrikant I.
目的：本研究开发并测试了一种文化上合适的、以教会为基础的干预措施，以改善糖尿病的自我管理。研究设计与方法这是一项随机试验，在北卡罗来纳州中部的24个非裔美国人教堂进行。教会被随机分配接受特殊干预（SI， 13个教堂，117名参与者）或最小干预（MI， 11个教堂，84名参与者）。SI包括8个月的强化阶段，包括1次个人咨询访问，12次小组会议，每月电话联系和3张鼓励明信片，然后是4个月的强化阶段，包括每月电话联系。MI通过邮件收到了标准的教育小册子。在8个月和12个月时评估结果；主要终点是8个月A1C水平的比较。结果基线时平均年龄59岁，糖化血红蛋白7.8%，体重指数35.0 kg/m(2)；64%的参与者是女性。在接受8个月随访的174名（87%）参与者中，SI患者的平均糖化血红蛋白（根据基线和组随机化调整）为7.4%，MI患者为7.8%，差异为0.4%（95%置信区间[CI]， 0.1-0.6, P = 0.009）。在调整了其他变量的较大模型中，差异为0.5% （95% CI, 0.2-0.7, P < 0.001）。12个月时，两组间差异无统计学意义。与MI组相比，SI组的糖尿病知识和糖尿病相关生活质量显著提高。在完成可接受性问卷的SI参与者中，干预成分和材料被评为高度可接受。结论以教会为基础的干预得到了参与者的好评，并改善了短期代谢控制。
PurposeThis study developed and tested a culturally appropriate, church-based intervention to improve diabetes self-management.Research Design and MethodsThis was a randomized trial conducted at 24 African American churches in central North Carolina. Churches were randomized to receive the special intervention (SI; 13 churches, 117 participants) or the minimal intervention (MI; 11 churches, 84 participants). The SI included an 8-month intensive phase, consisting of 1 individual counseling visit, 12 group sessions, monthly phone contacts, and 3 encouragement postcards, followed by a 4-month reinforcement phase including monthly phone contacts. The MI received standard educational pamphlets by mail. Outcomes were assessed at 8 and 12 months; the primary outcome was comparison of 8-month A1C levels.ResultsAt baseline, the mean age was 59 years, A1C 7.8%, and body mass index 35.0 kg/m(2); 64% of participants were female. For the 174 (87%) participants returning for 8-month measures, mean A1C (adjusted for baseline and group randomization) was 7.4% for SI and 7.8% for MI, with a difference of 0.4% (95% confidence interval [CI], 0.1-0.6, P = .009). In a larger model adjusting for additional variables, the difference was 0.5% (95% CI, 0.2-0.7, P < .001). At 12 months, the difference between groups was not significant. Diabetes knowledge and diabetes-related quality of life significantly improved in the SI group compared with the MI group. Among SI participants completing an acceptability questionnaire, intervention components and materials were rated as highly acceptable.ConclusionsThe church-based intervention was well received by participants and improved short-term metabolic control.