Ngāti and healthy: translating diabetes prevention evidence into community action
Ngāti and healthy: translating diabetes prevention evidence into community action
复制标题
Ngāti 与健康：将糖尿病预防证据转化为社区行动
作者：
D. Tipene;K. Coppell;Sally Abel;H. Pahau;Terry H Ehau;J. Mann
简介：2 型糖尿病 (T2DM) 是新西兰毛利人的一个主要健康问题。临床试验已经证明了预防 T2DM 的潜力，但旨在预防糖尿病的社区公共卫生计划是否有效尚未得到检验。目标：描述干预措施的规划和设计，旨在将 T2DM 预防临床试验证据转化为高风险毛利社区的社区范围内的人口健康干预措施。方法：当地糖尿病护士（她本人也是部落成员）听取了社区对糖尿病负担的担忧，并与当地长大的学者进行了讨论。随后进行了项目规划。干预措施及其评估是使用参与式社区发展模型设计的。计划的干预措施包括三个组成部分：传达健康生活方式信息的社区范围内的健康促进举措、对已识别的高风险个人及其大家庭的社区教育和监测，以及旨在适应当地环境以支持生活方式改变的结构性战略。评估计划涉及中断时间序列调查以及形成性和过程评估，而不是随机对照试验设计。讨论：咨询社区、验证社区关注的问题以及优先考虑文化和道德问题是关键步骤。从一开始就在医疗服务提供者和学术研究团队成员之间建立良好关系所花费的时间被证明是非常宝贵的，因为团队团结一致解决项目规划和实施挑战，例如由于我们在道德和文化上适当的非随机对照试验评估设计而出现的资金障碍。干预前调查显示糖尿病（13%）、胰岛素抵抗（33%）和危险因素的发病率很高，并为积极而非消极的生活方式干预信息提供了证据。结论：社区范围内的生活方式干预措施有可能降低高风险社区 2 型糖尿病和其他慢性病的发病率，但需要卫生部门的高度承诺和社区的支持。充分的承诺、领导力、规划和资源至关重要。
Introduction: Type 2 diabetes mellitus (T2DM) is a major health issue in New Zealand Māori. Clinical trials have demonstrated potential for the prevention of T2DM, but whether community public health programmes aiming to prevent diabetes are effective is untested. Objective: To describe the planning and design of an intervention aiming to translate T2DM prevention clinical trial evidence into a community-wide population health intervention in a high risk predominantly Māori community. Approach: Community concerns about the diabetes burden were heard by the local diabetes nurse, herself a tribal member, and discussed with a locally raised academic. Project planning ensued. The intervention and its evaluation were designed using a participatory community development model. The planned intervention had three components: community-wide health promotion initiatives conveying healthy lifestyle messages, community education and monitoring for identified high-risk individuals and their extended families, and a structural strategy aimed at adapting local environments to support lifestyle changes. The evaluation plan involved interrupted time series surveys coupled with formative and process evaluations rather than a randomised control trial design. Discussion: Consulting communities, validating community concerns and prioritising cultural and ethical issues were key steps. Time spent developing good relationships amongst the health provider and academic research team members at the outset proved invaluable, as the team were united in addressing the project planning and implementation challenges, such as funding obstacles that arose because of our ethically and culturally appropriate non-randomised control trial evaluation design. The pre-intervention survey demonstrated high rates of diabetes (13%), insulin resistance (33%) and risk factors, and provided evidence for positive, as opposed to negative, lifestyle intervention messages. Conclusion: Community-wide lifestyle interventions have the potential to reduce rates of type 2 diabetes and other chronic diseases in high-risk communities, but require a high level of commitment from the health sector and buy-in from the community. Adequate commitment, leadership, planning and resources are essential.
影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
基于社区的心血管疾病预防研究分析——北卡累利阿项目和明尼苏达心脏健康计划的评估问题。
影响因子：
7.7
作者：
Salonen,JT;Kottke,TE;JacobsJr,DR;Hannan,PJ
通讯作者：
Hannan,PJ