在农村教会环境中实施糖尿病预防计划的促进因素和障碍:使用实施研究综合框架进行定性研究。

IF 3.1 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Smita Rawal, Caleb A Snead, Frantz D Soiro, Jeffery Lawrence, Brian M Rivers, Henry N Young
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引用次数: 0

摘要

目的:疾病预防控制中心的糖尿病预防计划(DPP)是预防 2 型糖尿病(T2D)的有效生活方式干预措施。然而,DPP 在农村地区的实施却很有限。本研究旨在通过社区-学术合作在农村教会环境中实施 DPP,并确定实施的促进因素和障碍,从而弥补这一不足:这是一项横断面定性研究。在实施研究综合框架(CFIR)指导下进行的半结构式访谈评估了教会领袖和生活方式指导员对在农村教会实施 DPP 的看法。采用归纳法进行专题分析,以确定关键主题;然后,将这些新出现的主题与 CFIR 构建进行演绎关联。研究结果采用 COREQ 准则进行报告:25 名利益相关者参与了研究。实施 DPP 的促进因素包括其在预防 T2D 方面的循证有效性,以及学术合作伙伴在资金、培训和沟通方面的支持。此外,DPP 与社区需求的契合,以及牧师在参与者招募中的积极参与,也为该计划的实施提供了支持。一些障碍阻碍了 DPP 的实施,包括交通和儿童保育问题,以及计划参与者的医疗条件/残疾限制了他们的参与。此外,农村居民不愿改变生活方式以及对家庭教会的忠诚也对他们参与 DPP 计划构成了挑战:本研究确定了影响农村社区实施 DPP 的背景因素。研究结果凸显了采取有针对性的策略的重要性,这些策略既要发挥促进因素的作用,又要积极主动地解决障碍,包括农村居民不愿意参加教会以外的活动、抵制生活方式的改变以及交通问题,以确保 DPP 在农村地区的成功实施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Facilitators and barriers to implementing the Diabetes Prevention Program in rural church settings: A qualitative study using the Consolidated Framework for Implementation Research.

Purpose: The CDC's Diabetes Prevention Program (DPP) is an effective lifestyle intervention to prevent type 2 diabetes (T2D). However, DPP implementation in rural areas is limited. This study sought to address this gap by implementing DPP in rural church settings through a community-academic partnership and identifying implementation facilitators and barriers.

Methods: This was a cross-sectional qualitative study. Semistructured interviews guided by the Consolidated Framework for Implementation Research (CFIR) assessed church leaders' and lifestyle coaches' perceptions of implementing DPP in rural churches. Thematic analysis was used to identify key themes through an inductive approach; then, these emergent themes were deductively linked to CFIR constructs. COREQ guidelines were used to report study findings.

Findings: Twenty-five stakeholders participated. Facilitators to implementing DPP included its evidence-based effectiveness in preventing T2D, as well as support from the academic partner in terms of funding, training, and communication. Additionally, DPP's alignment with community needs, along with the active engagement of pastors in participant recruitment, supported implementation. Several barriers hindered DPP implementation, including transportation and childcare issues, as well as program participants' medical conditions/disabilities limiting their participation. Furthermore, rural residents' reluctance to adopt lifestyle changes and loyalty to family churches posed challenges to their engagement in DPP.

Conclusions: This study identified contextual factors influencing DPP implementation in rural communities. Findings highlight the importance of tailored strategies that leverage facilitators while proactively addressing barriers, including rural residents' reluctance to attend programs outside their church, resistance to lifestyle changes, and transportation issues to ensure successful DPP implementation in rural areas.

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来源期刊
Journal of Rural Health
Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
6.10%
发文量
86
审稿时长
>12 weeks
期刊介绍: The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.
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