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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Randomized controlled trial of the effects of nurse case manager and community health worker interventions on risk factors for diabetes-related complications in urban African Americans.
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Randomized controlled trial of the effects of nurse case manager and community health worker interventions on risk factors for diabetes-related complications in urban African Americans.

机译：护士病例经理和社区卫生工作者干预措施对城市非裔美国人糖尿病相关并发症危险因素的影响的随机对照试验。

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BACKGROUND: African Americans suffer disproportionately from diabetes complications, but little research has focused on how to improve diabetic control in this population. There are also few or no data on a combined primary care and community-based intervention approach. METHODS: We randomly assigned 186 urban African Americans with type 2 diabetes (76% female, mean A SD age 59 A 9 years) to 1 of 4 parallel arms: (1) usual care only; (2) usual care + nurse case manager (NCM); (3) usual care + community health worker (CHW); (4) usual care + nurse case manager/community health worker team. Using the framework of the Precede-Proceed behavioral model, interventions included patient counseling regarding self-care practices and physician reminders. RESULTS: The 2-year follow-up visit was completed by 149 individuals (84%). Compared to the Usual care group, the NCM group and the CHW group had modest declines in HbA(1c) over 2 years (0.3 and 0.3%, respectively), and the combined NCM/CHW group had a greater decline in HbA(1c) (0.8%. P = 0.137). After adjustment for baseline differences and/or follow-up time, the combined NCM/CHW group showed improvements in triglycerides (-35.5 mg/dl; P = 0.041) and diastolic blood pressure, compared to the usual care group (-5.6 mmHg; P = 0.042). CONCLUSIONS: Combined NCM/CHW interventions may improve diabetic control in urban African Americans with type 2 diabetes. Although results were clinically important, they did not reach statistical significance. This approach deserves further attention as a means to reduce the excess risk of diabetic complications in African Americans.
机译：背景：非裔美国人因糖尿病并发症而遭受的痛苦不成比例，但很少有研究集中在如何改善该人群的糖尿病控制上。关于基本医疗和社区干预相结合的方法的数据也很少甚至没有。方法：我们将186名患有2型糖尿病的城市非裔美国人（76％的女性，平均ASD年龄59 A 9岁）随机分配给4个平行臂中的1个： （2）日常护理+护士个案经理（NCM）; （3）日常护理+社区卫生工作者（CHW）; （4）日常护理+护士病例经理/社区卫生工作者团队。使用“先行行为”行为模型的框架，干预措施包括有关自我护理实践和医生提醒的患者咨询。结果：149位患者（84％）完成了为期2年的随访。与常规护理组相比，NCM组和CHW组在2年中HbA（1c）的下降幅度不大（分别为0.3％和0.3％），并且NCM / CHW组合组的HbA（1c）的下降幅度更大（0.8％。P= 0.137）。调整基线差异和/或随访时间后，与常规护理组（-5.6 mmHg; 5.6 mgHg）相比，NCM / CHW联合治疗组的甘油三酸酯（-35.5 mg / dl; P = 0.041）和舒张压得到改善。 P = 0.042）。结论：NCM / CHW联合干预措施可改善2型糖尿病都市非洲裔美国人的糖尿病控制。尽管结果在临床上很重要，但未达到统计学意义。这种方法作为减少非裔美国人糖尿病并发症过多风险的一种方法值得进一步关注。

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