Tayebeh Shirvani1, Zeinab Javadivala1, Somayeh Azimi1, Abdolreza Shaghaghi1, Zahra Fathifar2, H D R Devender Bhalla3,4, Mohammadhiwa Abdekhoda5, Haidar Nadrian6. 1. Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran. 2. Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran. 3. Iranian Epilepsy Association, Tehran, Iran. 4. Pôle Universitaire Euclide Intergovernmental UN Treaty 49006/49007, Bangui, Central African Republic. 5. Department of Health Informatics, Faculty of Health Informatics and Management, Tabriz University of Medical Sciences, Tabriz, Iran. 6. Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. haidarnadrian@gmail.com.
Abstract
PURPOSE: Our objective was to estimate the change in community-based education interventions throughout the world that may effectuate in risk parameters of type II diabetes (T2D), including the diabetes incidence rate, fasting blood glucose, hemoglobin A1C, body mass index, waist circumference, and systolic and diastolic blood pressure. METHODS: A comprehensive search for globally eligible studies was conducted on PubMed, Embase, ProQuest, CINAHL nursing & allied health source, Cochrane Library, Google Scholar, conference proceedings, and reference lists. Data were extracted using JBI standardized data extraction tool. The primary outcome variables were diabetes incidence rate, fasting blood sugar (FBS), hemoglobin A1c (HbAlc), body mass index (BMI), waist circumference (WC), systolic/diastolic blood pressure (s/d BP). Random-effects meta-analysis and sub-group analyses were conducted. RESULTS: Nineteen interventional studies were included in the review, and ten studies were pooled in the meta-analysis (n = 16,106, mean age = 41.5 years). The incidence rate of T2D was reported in three trials, within which the risk of developing T2D was reduced by 54.0% in favor of community-based educational interventions, (RR = 0.54, 95% CI = 0.38-0.75; p < 0.001). In eleven (n = 11,587) and six (n = 6416) studies, the pooled mean differences were - 0.33 (95% CI: - 0.45 to - 0.20, p < 0.0001) and - 0.15 (95% CI: - 0.28 to - 0.03, p < 0.0001) for FBS and HbA1c levels, respectively. Positive significant effects were observed on reducing BMI [pooled mean difference = - 0.47 (95% CI: - 0.66 to - 0.28), I2 = 95.7%, p < 0.0001] and WC [pooled mean difference = - 0.66 (95% CI: - 0.89 to - 0.43), I2 = 97.3%, p < 0.0001]. The use of theoretical frameworks was found to provide a 48.0% change in fasting blood sugar. CONCLUSIONS: Based on a comprehensive data collection of about 16,106 participants and reasonable analyses, we conclude that educational interventions may reduce diabetes incidence by 54.0%, particularly through reductions in fasting blood glucose, body mass index, and waist circumference. The diabetes risk parameters may favorably improve irrespective of the duration of intervention, at as low as 6 months. The application of theoretical frameworks while designing educational interventions is also encouraged. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018115877.
PURPOSE: Our objective was to estimate the change in community-based education interventions throughout the world that may effectuate in risk parameters of type II diabetes (T2D), including the diabetes incidence rate, fasting blood glucose, hemoglobin A1C, body mass index, waist circumference, and systolic and diastolic blood pressure. METHODS: A comprehensive search for globally eligible studies was conducted on PubMed, Embase, ProQuest, CINAHL nursing & allied health source, Cochrane Library, Google Scholar, conference proceedings, and reference lists. Data were extracted using JBI standardized data extraction tool. The primary outcome variables were diabetes incidence rate, fasting blood sugar (FBS), hemoglobin A1c (HbAlc), body mass index (BMI), waist circumference (WC), systolic/diastolic blood pressure (s/d BP). Random-effects meta-analysis and sub-group analyses were conducted. RESULTS: Nineteen interventional studies were included in the review, and ten studies were pooled in the meta-analysis (n = 16,106, mean age = 41.5 years). The incidence rate of T2D was reported in three trials, within which the risk of developing T2D was reduced by 54.0% in favor of community-based educational interventions, (RR = 0.54, 95% CI = 0.38-0.75; p < 0.001). In eleven (n = 11,587) and six (n = 6416) studies, the pooled mean differences were - 0.33 (95% CI: - 0.45 to - 0.20, p < 0.0001) and - 0.15 (95% CI: - 0.28 to - 0.03, p < 0.0001) for FBS and HbA1c levels, respectively. Positive significant effects were observed on reducing BMI [pooled mean difference = - 0.47 (95% CI: - 0.66 to - 0.28), I2 = 95.7%, p < 0.0001] and WC [pooled mean difference = - 0.66 (95% CI: - 0.89 to - 0.43), I2 = 97.3%, p < 0.0001]. The use of theoretical frameworks was found to provide a 48.0% change in fasting blood sugar. CONCLUSIONS: Based on a comprehensive data collection of about 16,106 participants and reasonable analyses, we conclude that educational interventions may reduce diabetes incidence by 54.0%, particularly through reductions in fasting blood glucose, body mass index, and waist circumference. The diabetes risk parameters may favorably improve irrespective of the duration of intervention, at as low as 6 months. The application of theoretical frameworks while designing educational interventions is also encouraged. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018115877.
Authors: Regitze Anne Saurbrey Pals; Timothy Skinner; Elena Rey Velasco; Dan Grabowski Journal: Child Care Health Dev Date: 2020-01-12 Impact factor: 2.508
Authors: Jeffrey A Katula; Mara Z Vitolins; Erica L Rosenberger; Caroline S Blackwell; Timothy M Morgan; Michael S Lawlor; David C Goff Journal: Diabetes Care Date: 2011-05-18 Impact factor: 19.112