Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes
Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes
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DOI：
10.1179/174592006x93851
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发表时间：
2006-03-01
期刊：
影响因子：
1.3
通讯作者：
Merenich, John
中科院分区：
文献类型：
--
作者：
Glasgow, Russell E.;Nutting, Paul A.;Merenich, John
目的：有必要采取实际、有效和广泛的糖尿病自我管理干预措施，改变健康饮食和减肥等生活方式。本研究的目的是评估这样一个计算机辅助intervention.Methods：2型糖尿病初级保健患者（n = 335）从收费服务和健康维护组织设置随机社会认知理论为基础的定制自我管理（TSM）或计算机辅助增强日常护理（UC）。干预措施包括计算机辅助自我管理评估和反馈，量身定制的目标设定，障碍识别和解决问题，然后是健康顾问互动和随访电话。结果是饮食行为的变化（脂肪和水果/蔬菜摄入量），血红蛋白A1 C（HbA 1C），血脂，体重，生活质量，和depression.Results：TSM患者减少饮食脂肪摄入量和体重显着超过UC患者在2个月的后续行动。在基线时HbA 1c、血脂或抑郁水平升高的患者中，存在一致的有利于干预的方向性趋势，但这些差异未达到显著性。干预被证明是可行的，并成功地实施了各种staff.Conclusions：这种相对低强度的干预呼吁一个大的，一般具有代表性的样本的患者，得到了很好的实施，并产生了改善有针对性的行为。这一实际的临床试验传播的影响进行了讨论。
Objective: There is a need for practical, efficient and broad-reaching diabetes self-management interventions that can produce changes in lifestyle behaviours such as healthy eating and weight loss. The objective of this study was to evaluate such a computer-assisted intervention.Methods: Type 2 diabetes primary care patients (n = 335) from fee-for-service and health maintenance organization settings were randomized to social cognitive theory-based tailored self-management (TSM) or computer-aided enhanced usual care (UC). Intervention consisted of computer-assisted self-management assessment and feedback, tailored goal-setting, barrier identification, and problem-solving, followed by health counsellor interaction and follow-up calls. Outcomes were changes in dietary behaviours (fat and fruit/vegetable intake), haemoglobin A1c (HbA1c), lipids, weight, quality of life, and depression.Results: TSM patients reduced dietary fat intake and weight significantly more than UC patients at the 2-month follow-up. Among patients having elevated levels of HbA1c, lipids or depression at baseline, there were consistent directional trends favouring intervention, but these differences did not reach significance. The intervention proved feasible and was implemented successfully by a variety of staff.Conclusions: This relatively low-intensity intervention appealed to a large, generally representative sample of patients, was well implemented, and produced improvement in targeted behaviours. Implications of this practical clinical trial for dissemination are discussed.