利用数字干预：评估肯尼亚12周糖尿病总生活方式改变计划的影响

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.2025.05.090

Alice Ojwang PhD, RD, CDE, Atieno Jalango, Nyawira Maina DR, Mildred Nyange

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引用次数: 0

摘要

目的一项为期12周的数字干预，旨在使2型糖尿病和糖尿病前期患者改善血糖控制，减少药物依赖，并采取可持续的生活方式改变。理论或研究的使用健康信念模型和社会认知理论通过增强知识、自我效能和坚持生活方式的改变来为行为改变策略提供信息。目标受众：在肯尼亚，通过健康保险合作伙伴关系、企业健康计划和社区外展，患有2型糖尿病和前驱糖尿病的成年人（25-70岁）。DTLC计划通过每周90分钟的Zoom会议交付，由专家协调员主持，并由WhatsApp参与提供持续的同伴支持，问责制和专家反馈。营养课程包括碳水化合物智力、膳食计划、份量控制和情绪化饮食。血糖管理主题包括血糖监测、药物调整、足部护理和糖尿病并发症预防。其他会议讨论了压力管理、社会网络和健康，以及睡眠对糖尿病控制的影响。参与者在WhatsApp上分享每周的美食图片、健身更新和进度跟踪，加强学习和社区支持。评估方法采用前后评估设计评估参与者结果，数据来自65名参与者，回复率为80%（52名参与者）。评估包括HbA1c变化、体重减轻、药物调整和自我报告的糖尿病管理信心。采用描述性统计和推理统计进行分析。62%的参与者降低了他们的HbA1c水平，平均降低了2.57个单位。43%的人减少或停用糖尿病药物，79%的人体重减轻，平均减少4.97公斤。百分之九十八（98%）的人报告说，他们对控制糖尿病的信心有所提高。然而，只有9%的人参加了足部检查，这凸显了预防性糖尿病护理方面的差距。结论DTLC项目在血糖控制、体重管理和药物减少方面有显著改善，加强了数字化糖尿病教育的有效性。未来的建议包括通过企业健康倡议扩大该计划，加强预防保健教育，以及整合人工智能驱动的数字健康工具。DTLC为肯尼亚及其他地区的糖尿病行为改变提供了一个可扩展的、具有成本效益的模式。FundingNone

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"Leveraging Digital Interventions: Evaluating the Impact of the 12-Week Diabetes Total Lifestyle Change Program in Kenya"

Objective

A 12-week digital intervention designed to empower individuals with type 2 diabetes and pre-diabetes to improve glycemic control, reduce medication dependence, and adopt sustainable lifestyle changes.

Use of Theory or Research

The Health Belief Model and Social Cognitive Theory informed behavior change strategies by enhancing knowledge, self-efficacy, and adherence to lifestyle modifications.

Target Audience

Adults (ages 25-70) with type 2 diabetes and prediabetes through health insurance partnerships, corporate wellness programs, and community-based outreach in Kenya.

Program Description

The DTLC Program was delivered through weekly 90-minute Zoom sessions led by expert facilitators and supported by WhatsApp engagement for continuous peer support, accountability, and expert feedback. Nutrition sessions covered carb intelligence, meal planning, portion control, and emotional eating. Blood sugar management topics included glucose monitoring, medication adjustments, foot care, and diabetes complications prevention. Additional sessions addressed stress management, social networks and health, and sleep’s impact on diabetes control. Participants shared weekly food pictures, fitness updates, and progress tracking on WhatsApp, reinforcing learning and community support.

Evaluation Methods

A pre-post evaluation design assessed participant outcomes, with data from 65 participants and an 80% response rate (52 participants). Evaluations included HbA1c changes, weight loss, medication adjustments, and self-reported confidence in diabetes management. Descriptive and inferential statistics were used for analysis.

Results

Sixty-two percent (62%) of participants lowered their HbA1c levels, with an average reduction of 2.57 units. Forty-three percent (43%) reduced or discontinued diabetes medication, while 79% achieved weight loss, with an average reduction of 4.97 kg. Ninety-eight percent (98%) reported improved confidence in managing their diabetes. However, only 9% attended a foot examination, highlighting a gap in preventive diabetes care.

Conclusions

The DTLC program demonstrated significant improvements in glycemic control, weight management, and medication reduction, reinforcing the effectiveness of digital diabetes education. Future recommendations include expanding the program through corporate wellness initiatives, enhancing preventive care education, and integrating AI-powered digital health tools. DTLC offers a scalable, cost-effective model for diabetes behavior change in Kenya and beyond.

Funding

None

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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.