Equity impact of participatory learning and action community mobilisation and mHealth interventions to prevent and control type 2 diabetes and intermediate hyperglycaemia in rural Bangladesh: analysis of a cluster randomised controlled trial.
Equity impact of participatory learning and action community mobilisation and mHealth interventions to prevent and control type 2 diabetes and intermediate hyperglycaemia in rural Bangladesh: analysis of a cluster randomised controlled trial.
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DOI：
10.1136/jech-2021-217293
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发表时间：
2022-06
影响因子：
6.3
通讯作者：
Fottrell, Edward
中科院分区：
文献类型：
--
作者：
Pires, Malini;Shaha, Sanjit;King, Carina;Morrison, Joanna;Nahar, Tasmin;Ahmed, Naveed;Jennings, Hannah Maria;Akter, Kohenour;Haghparast-Bidgoli, Hassan;Khan, A. K. Azad;Costello, Anthony;Kuddus, Abdul;Azad, Kishwar;Fottrell, Edward
一项关于移动健康和参与式学习与行动（PLA）社区动员干预的聚类随机试验表明，PLA显著降低了孟加拉国农村成年人中中度高血糖和2型糖尿病（T2DM）的患病率以及T2DM的发病率；移动健康改善了知识，但对血糖结果没有影响。我们探讨了干预范围和影响的公平性。通过访谈调查、空腹血糖和2小时口服葡萄糖耐量试验，对年龄≥30岁的人群样本进行中度高血糖和T2DM的干预程度和主要结局进行评估。使用随机效应逻辑回归估计年龄分层、性别分层和财富分层的干预效果。解放军参与者与非参与者相似，尽管女性参与者比非参与者更年轻，更有可能结婚。在接触和未接触移动健康干预的个体之间观察到年龄、教育、财富和婚姻状况的差异。PLA降低了所有年龄、性别和财富阶层的2型糖尿病和中度高血糖的患病率。2年T2DM发病率至少降低51% (0.49,95% CI 0.26 - 0.92)，除了年龄最大和最贫困的人群。移动健康对血糖结果的影响仅在最年轻的组中观察到，2年T2DM发病率降低了47% （0.53,95% CI 0.28至1.00）。解放军对所有阶层的巨大影响表明了一种高度有效和公平的干预。移动医疗可能更适合针对高风险、年轻的人群。ISRCTN41083256。
A cluster randomised trial of mHealth and participatory learning and action (PLA) community mobilisation interventions showed that PLA significantly reduced the prevalence of intermediate hyperglycaemia and type 2 diabetes mellitus (T2DM) and the incidence of T2DM among adults in rural Bangladesh; mHealth improved knowledge but showed no effect on glycaemic outcomes. We explore the equity of intervention reach and impact. Intervention reach and primary outcomes of intermediate hyperglycaemia and T2DM were assessed through interview surveys and blood fasting glucose and 2-hour oral glucose tolerance tests among population-based samples of adults aged ≥30 years. Age-stratified, gender-stratified and wealth-stratified intervention effects were estimated using random effects logistic regression. PLA participants were similar to non-participants, though female participants were younger and more likely to be married than female non-participants. Differences including age, education, wealth and marital status were observed between individuals exposed and those not exposed to the mHealth intervention. PLA reduced the prevalence of T2DM and intermediate hyperglycaemia in all age, gender and wealth strata. Reductions in 2-year incidence of T2DM of at least 51% (0.49, 95% CI 0.26 to 0.92) were observed in all strata except among the oldest and least poor groups. mHealth impact on glycaemic outcomes was observed only among the youngest group, where a 47% reduction in the 2-year incidence of T2DM was observed (0.53, 95% CI 0.28 to 1.00). Large impacts of PLA across all strata indicate a highly effective and equitable intervention. mHealth may be more suitable for targeting higher risk, younger populations. ISRCTN41083256.
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影响因子：
2.8
作者：
Khatun F;Heywood AE;Hanifi SMA;Rahman MS;Ray PK;Liaw ST;Bhuiya A
通讯作者：
Bhuiya A
影响因子：
6.3
作者：
Braveman, P;Gruskin, S
通讯作者：
Gruskin, S
影响因子：
3.9
作者：
Mannell J;Davis K;Akter K;Jennings H;Morrison J;Kuddus A;Fottrell E
通讯作者：
Fottrell E
影响因子：
7.7
作者：
Houweling, Tanja A. J.;Looman, Caspar W. N.;Costello, Anthony
通讯作者：
Costello, Anthony
影响因子：
3.2
作者：
Hossen, Abul;Westhues, Anne
通讯作者：
Westhues, Anne