SangNam Ahn1, Joonhyung Lee2, Jenny Bartlett-Prescott3, Lisa Carson4, Lindsey Post1, Kenneth D Ward5. 1. 1 Division of Health Systems Management and Policy, The University of Memphis School of Public Health, Memphis, TN, USA. 2. 2 Fogelman College of Business and Economics, The University of Memphis, Memphis, TN, USA. 3. 3 Integrated Health Programs, Church Health, Memphis, TN, USA. 4. 4 Methodist Le Bonheur Healthcare Hospital, Memphis, TN, USA. 5. 5 Division of Social and Behavioral Sciences, The University of Memphis School of Public Health, Memphis, TN, USA.
Abstract
PURPOSE: To examine the effects of a community-based behavioral intervention with multiple components on health outcomes among low-income and uninsured adults who were obese and had diabetes and treated in a "real-world" setting. DESIGN: A longitudinal design with a retrospective comparison group was used to examine the ability of a health promotion program to improve body mass index (BMI) and hemoglobin A1c (HbA1c) among 87 treatment group and 62 comparison group participants. SETTING: Urban/metropolitan city in the United States. INTERVENTION: A community-based behavioral intervention with 3 components including health-coach visits, registered dietitian visits, and exercise consultations delivered over 12 months. MEASURES: Biometric measurements were collected at baseline, 3, 6, 9, 12, and 18 months, whereas self-reported measurements were collected at baseline, 6 months, and 12 months. ANALYSIS: Linear mixed models with participant-level random intercepts were fitted for BMI and HbA1c. RESULTS: The treatment group demonstrated reductions in BMI (percentage change = -2.1%, P < .001) and HbA1c (-0.6%, P < .001) as well as improvement in diabetes knowledge (+5.4%, P = .025), whereas the comparison group did not show any improvements in biometric measures. Dietitian visits were the most effective treatment component to reduce HbA1c (coefficient = -0.08, P = .025). CONCLUSION: Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.
PURPOSE: To examine the effects of a community-based behavioral intervention with multiple components on health outcomes among low-income and uninsured adults who were obese and had diabetes and treated in a "real-world" setting. DESIGN: A longitudinal design with a retrospective comparison group was used to examine the ability of a health promotion program to improve body mass index (BMI) and hemoglobin A1c (HbA1c) among 87 treatment group and 62 comparison group participants. SETTING: Urban/metropolitan city in the United States. INTERVENTION: A community-based behavioral intervention with 3 components including health-coach visits, registered dietitian visits, and exercise consultations delivered over 12 months. MEASURES: Biometric measurements were collected at baseline, 3, 6, 9, 12, and 18 months, whereas self-reported measurements were collected at baseline, 6 months, and 12 months. ANALYSIS: Linear mixed models with participant-level random intercepts were fitted for BMI and HbA1c. RESULTS: The treatment group demonstrated reductions in BMI (percentage change = -2.1%, P < .001) and HbA1c (-0.6%, P < .001) as well as improvement in diabetes knowledge (+5.4%, P = .025), whereas the comparison group did not show any improvements in biometric measures. Dietitian visits were the most effective treatment component to reduce HbA1c (coefficient = -0.08, P = .025). CONCLUSION: Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.
Entities:
Keywords:
behavioral intervention with multiple components; body mass index; exercise consultations; hbA1c; health promotion; health-coach visit; registered dietitian visit; twin epidemic of diabetes and obesity; vulnerable populations
Authors: Peter Anthamatten; Deborah S K Thomas; Devon Williford; Jennifer C Barrow; Kirk A Bol; Arthur J Davidson; Sara J Deakyne Davies; Emily McCormick Kraus; David C Tabano; Matthew F Daley Journal: Public Health Rep Date: 2020-02-13 Impact factor: 2.792
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