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首页> 外文期刊>Diabetes care >Comparative Effectiveness and Maintenance of Diabetes Self-Management Education Interventions for Marshallese Patients With Type 2 Diabetes: A Randomized Controlled Trial
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Comparative Effectiveness and Maintenance of Diabetes Self-Management Education Interventions for Marshallese Patients With Type 2 Diabetes: A Randomized Controlled Trial

机译：2型糖尿病患者糖尿病自我管理教育干预措施的比较效果和维持：随机对照试验

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OBJECTIVE Marshallese adults experience high rates of type 2 diabetes. Previous diabetes self-management education (DSME) interventions among Marshallese were unsuccessful. This study compared the extent to which two DSME interventions improved glycemic control, measured on the basis of change in glycated hemoglobin (HbA(1c)). RESEARCH DESIGN AND METHODS A two-arm randomized controlled trial compared a standard-model DSME (standard DSME) with a culturally adapted family-model DSME (adapted DSME). Marshallese adults with type 2 diabetes (n = 221) received either standard DSME in a community setting (n = 111) or adapted DSME in a home setting (n = 110). Outcome measures were assessed at baseline, immediately after the intervention, and at 6 and 12 months after the intervention and were examined with adjusted linear mixed-effects regression models. RESULTS Participants in the adapted DSME arm showed significantly greater declines in mean HbA(1c) immediately (-0.61% [95% CI -1.19, -0.03]; P = 0.038) and 12 months (-0.77% [95% CI -1.38, -0.17]; P = 0.013) after the intervention than those in the standard DSME arm. Within the adapted DSME arm, participants had significant reductions in mean HbA(1c) from baseline to immediately after the intervention (-1.18% [95% CI -1.55, -0.81]), to 6 months (-0.67% [95% CI -1.06, -0.28]), and to 12 months (-0.87% [95% CI -1.28, -0.46]) (P < 0.001 for all). Participants in the standard DSME arm had significant reductions in mean HbA(1c) from baseline to immediately after the intervention (-0.55% [95% CI -0.93, -0.17]; P = 0.005). CONCLUSIONS Participants receiving the adapted DSME showed significantly greater reductions in mean HbA(1c) immediately after and 12 months after the intervention than the reductions among those receiving standard DSME. This study adds to the body of research that shows the potential effectiveness of culturally adapted DSME that includes participants' family members.
机译：客观马歇尔成年人经历了2型糖尿病的高率。以前的糖尿病自助教育（DSME）在马歇斯中的干预措施不成功。该研究比较了两种DSME干​​预的程度，基于糖化血红蛋白（HBA（1C））的变化测量。研究设计与方法双臂随机对照试验与具有文化适应的家庭模型DSME（适应DSME）进行了标准模型DSME（标准DSME）。 Marshallese成年人具有2型糖尿病（n = 221），在社区设置（n = 111）中收到标准DSME或在家庭设置中调整DSME（n = 110）。结果措施在介入后立即在基线进行评估，干预后的6和12个月，并通过调整的线性混合效应回归模型进行检查。结果适应性DSME臂的参与者在平均HBA（1c）中显示出明显更大的下降（1c）（-0.61％[95％CI -1.19，-0.03]; p = 0.038）和12个月（-0.77％[95％CI -1.38 ，-0.17]; p = 0.013）干预后比标准DSME臂中的介入。在适应的DSME ARM中，参与者在介入后的基线（1c）的平均HBA（1C）中的平均值减少（-1.18％[95％CI -1.55，-0.81]），6个月（-0.67％[95％CI] -1.06，-0.28]）和12个月（-0.87％[95％CI -1.28，-0.46]）（P <0.001对于全部）。标准DSME臂中的参与者在干预后从基线（-0.55％[95％CI -0.93，-0.17]; p = 0.005），在基线上显着降低了基线的平均HBA（1C）。结论接受所适应的DSME的参与者在干预后12个月后立即表现出直接的HBA（1C）的显着更大，而不是接受标准DSME的减少。本研究增加了研究体系，表明了包括参与者家庭成员的文化适应的DSME的潜在有效性。

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