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首页> 外文期刊>BMC Public Health >Designing the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) self-management and support programme for UK African and Caribbean communities: a culturally tailored, complex intervention under-pinned by behaviour change theory
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Designing the Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) self-management and support programme for UK African and Caribbean communities: a culturally tailored, complex intervention under-pinned by behaviour change theory

机译：为英国非洲和加勒比海地区社区居民设计健康饮食和积极的糖尿病生活方式（HEAL-D）自我管理和支持计划：行为改变理论为基础的文化定制，复杂干预措施

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UK African and Caribbean (AfC) communities are disproportionately burdened by type 2 diabetes (T2D). Promoting healthy eating and physical activity through structured education is the cornerstone of T2D care, however cultural barriers may limit engagement in these communities. In addition, changes in lifestyle behaviour are shaped by normative influences within social groups and contextual factors need to be understood to facilitate healthful behaviour change. The Behaviour Change Wheel (BCW) and associated COM-B framework offer intervention designers a systematic approach to developing interventions. The aim of this study was to apply the BCW in the design of a culturally sensitive self-management support programme for T2D in UK AfC communities. An intervention development study was conducted. Focus groups were held with 41 AfC patients with T2D to understand healthful weight-management, diet and physical activity behaviours. The COM-B framework and BCW were used to evaluate the qualitative data, identify appropriate behaviour change techniques and specify the intervention components. Participants were motivated to avoid diabetes-related consequences although did not always understand the negative impact of their current health behaviours on long-term diabetes outcomes. Barriers to healthful behaviour included gaps in knowledge related to diet, physical activity and weight management guidance. In addition, motivation and social opportunity barriers included an acceptance of larger body sizes, rejection of body mass index for weight guidance and cultural identity being strongly linked to consumption of traditional starches. There was a lack of social opportunity to perform moderate to vigorous physical activity, although walking and dance were culturally acceptable. The resulting Healthy Eating & Active Lifestyles for Diabetes (HEAL-D) intervention uses social support, social comparison, credible sources and demonstration as key behaviour change techniques. Use of COM-B and the BCW highlighted the need for an intervention to address motivational and social opportunity barriers to engaging in healthful behaviours, as well as addressing key gaps in knowledge. This framework facilitated the linkage of theoretical behaviour constructs with evidence-based behaviour change techniques, which will enable us to evaluate operationalisation of our chosen BCTs and their impact on behaviour change in a future feasibility study.
机译：英国非洲和加勒比海地区（AfC）社区患上2型糖尿病（T2D）的负担过多。通过结构化教育促进健康饮食和体育锻炼是T2D护理的基石，但是文化障碍可能会限制这些社区的参与。此外，生活方式行为的变化是由社会群体中的规范性影响所决定的，需要理解背景因素以促进健康的行为变化。行为改变轮（BCW）和相关的COM-B框架为干预设计人员提供了开发干预措施的系统方法。这项研究的目的是将BCW应用于英国AfC社区中针对T2D的具有文化敏感性的自我管理支持计划的设计。进行了一项干预发展研究。焦点小组与41名AfC T2D患者一起举行，以了解健康的体重管理，饮食和体育锻炼行为。 COM-B框架和BCW用于评估定性数据，确定适当的行为更改技术并指定干预成分。参与者有动力避免与糖尿病相关的后果，尽管他们并不总是了解他们当前的健康行为对长期糖尿病结局的负面影响。健康行为的障碍包括与饮食，体育锻炼和体重管理指南有关的知识差距。此外，动机和社会机会障碍包括接受更大的体型，拒绝体重指数以指导体重和文化认同与传统淀粉的消费密切相关。尽管步行和跳舞在文化上是可以接受的，但缺乏进行中度至剧烈运动的社交机会。由此产生的糖尿病健康饮食和积极生活方式（HEAL-D）干预将社会支持，社会比较，可靠的来源和示范作为关键的行为改变技术。 COM-B和BCW的使用强调了干预措施的必要性，以解决从事健康行为的动机和社会机会障碍，并解决知识方面的主要空白。该框架促进了理论行为构造与基于证据的行为改变技术之间的联系，这将使我们能够在未来的可行性研究中评估所选BCT的可操作性及其对行为改变的影响。

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