弥合糖尿病管理的差距：评估NC国家试点健康扩展糖尿病（HED）计划

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Nutrition Education and Behavior Pub Date : 2025-08-01 DOI:10.1016/j.jneb.2025.05.028

Basheerah Enahora PhD, RDN, LDN, Christy O'Connor MS, RD, LDN, Virginia Stage PhD, RDN, Sara Foreman RDN, LDN, CDCES, Michelle Parisi PhD, RDN, Windsor Sherril PhD, MHA, MBA, Danielle McFall MS, CHES, Samantha Kanny PhD, EB Odom RD, LDN, Elizabeth Baker BS, CHES, RHED, Qu'Asia Wilson BS

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引用次数: 0

摘要

目的探讨糖尿病健康推广（HED）对北卡罗莱纳州农村成人2型糖尿病患者糖尿病知识、自我保健、自我效能感、饮食摄入和身体活动、糖化血红蛋白（A1C）控制指标的影响。运用理论或研究北卡罗来纳州推广中心与克莱姆森推广中心和一个以社区为基础的临床合作伙伴合作，将HED扩展到三个服务不足的农村县。目标受众生活在伯蒂、赫特福德或北安普顿县的2型糖尿病成年人（18-64岁）项目描述hed是一个为期4个月的社区、非临床糖尿病自我管理支持（DSMS）项目，由训练有素的推广人员提供。HED干预包括8个两周一次的小组会议，会议之间有个性化的随访，以解决参与者的目标和挑战。克莱姆森为北卡州立大学的教师、员工和代理提供了为期两天的现场强化培训，重点是项目材料和实施。通过为期4个月的虚拟影子计划、教育网络研讨会和每月会议，为NC代理人提供持续的培训支持。评估方法在基线（T1）和干预后（T2）收集数据。参与者报告了人口统计、身高/体重、糖尿病知识和自我效能、营养和体育活动行为。临床合作伙伴测量A1C（抽血）。结果共纳入4组22例受试者；19人完成了课程（留存率86%）。参与者为女性，61.05岁（SD 19.02），黑人/非裔美国人（72.7%），非西班牙裔/拉丁裔（68.2%）。知识(术中;0.01)和自我效能感(p<；0.05)显著改善。受试者每日含糖饮料摄入量的减少(T1=18.2%, T2=9.1%, p<；0.03)和每周体力活动增加(T1=4.5%, T2=18.2%, p<；0.03)。BMI下降2.63 (T1-BMI= 37.22 (SD 8.53)；T2-BMI 192.82 lbs (SD 62.14), p<；0.001)。A1C水平降低但不显著(T1=7.27% (SD=1.63)；T2=6.21% (SD 2.25),p<；0.138)。结论：研究结果支持HED项目的可扩展性，可为农村服务不足的社区提供有效的、可获得的、基于社区的糖尿病教育和支持。FundingCDC

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Bridging the Gap in Diabetes Management: Evaluating the NC State Pilot of the Health Extension for Diabetes (HED) Program

Objective

Examine the effectiveness of Heath Extension for Diabetes (HED) on the diabetes knowledge self-care self-efficacy, dietary intake and physical activity, and A1C (glucose control indicator) of adults with type 2 diabetes living in rural North Carolina (NC).

Use of Theory or Research

NC State Extension partnered with Clemson Extension and a community-based clinical partner to expand HED to three rural underserved counties.

Target Audience

Adults (18-64 years) with type 2 diabetes living in Bertie, Hertford, or Northampton County in NC

Program Description

HED is a 4-month community-based, non-clinical diabetes self-management support (DSMS) program delivered by trained Extension Agents. HED intervention consisted of eight biweekly group sessions with personalized follow-up between sessions to address participant goals and challenges. Clemson provided a 2-day onsite, intensive training to NC State faculty, staff, and Agents focused on program materials and implementation. NC Agents were provided ongoing training support through a 4-month virtual shadowing program, educational webinars, and monthly meetings.

Evaluation Methods

Data were collected at baseline (T1) and post-intervention (T2). Participants reported demographics, height/weight, diabetes knowledge and self-efficacy, nutrition, and physical activity behaviors. Clinical partners measured A1C (blood draw).

Results

A total of 22 individuals enrolled in four cohorts; 19 completed the program (86% retention). Participants were female, 61.05 years (SD 19.02), Black/African American (72.7%), and Non-Hispanic/Latina (68.2%). Knowledge (p< 0.01) and self-efficacy (p< 0.05) significantly improved. Participants’ reduced daily consumption of sweetened beverages (T1=18.2%, T2=9.1%, p< 0.03) and increased weekly physical activity (T1=4.5%, T2=18.2%, p< 0.03). BMI decreased by 2.63 (T1-BMI= 37.22 (SD 8.53); T2-BMI 192.82 lbs (SD 62.14), p< 0.001). A1C levels decreased but were not significant (T1=7.27% (SD=1.63); T2=6.21% (SD 2.25),p< 0.138).

Conclusions

Findings support the scalability of the HED program for providing effective, accessible, community-based diabetes education and support in rural underserved communities.

Funding

CDC

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来源期刊

Journal of Nutrition Education and Behavior 医学-学科教育

CiteScore

4.20

自引率

11.50%

发文量

379

审稿时长

44 days

期刊介绍： The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior, is a refereed, scientific periodical that serves as a global resource for all professionals with an interest in nutrition education; nutrition and physical activity behavior theories and intervention outcomes; complementary and alternative medicine related to nutrition behaviors; food environment; food, nutrition, and physical activity communication strategies including technology; nutrition-related economics; food safety education; and scholarship of learning related to these areas. The purpose of JNEB is to document and disseminate original research and emerging issues and practices relevant to these areas worldwide. The Journal of Nutrition Education and Behavior welcomes evidence-based manuscripts that provide new insights and useful findings related to nutrition education research, practice and policy. The content areas of JNEB reflect the diverse interests in nutrition and physical activity related to public health, nutritional sciences, education, behavioral economics, family and consumer sciences, and eHealth, including the interests of community-based nutrition-practitioners. As the Society''s official journal, JNEB also includes policy statements, issue perspectives, position papers, and member communications.