Enhancing Support for Women w/Type 2 Diabetes: Follow-Up

加强对患有 2 型糖尿病的女性的支持：后续行动

• 批准号: 6807566
• 负责人: DEBORAH J TOOBERT
• 金额: $ 56.16万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6807566
• 关键词: body physical activity; cardiovascular disorder risk; clinical research; clinical trials; diabetes mellitus; diet; health behavior; human subject; interview; longitudinal human study; postmenopause; questionnaires; stress management; ultrasonography; women' s health

DESCRIPTION (provided by applicant): Coronary heart disease (CHD) is the leading cause of death and functional limitations among women in the U.S. Postmenopausal women with diabetes are at especially high risk of CHD, but CHD research with this population is very limited. This proposal addresses the poorly understood "natural history" of long-term maintenance of change in multiple behaviors (i.e., dietary, physical activity, and stress management) related to CHD risk, as well as the effects of theoretically important mediating variables on relapse and maintenance. The proposed study is a continuation of a current research project that has already demonstrated significant and consistent positive effects of a lifestyle change intervention on reduction of behavioral CHD risk factors in a sample of postmenopausal women with type 2 diabetes. This research relies on a framework that synthesizes social-cognitive, social-ecologic, and goal-systems theories. For the current study, 279 postmenopausal women having type 2 diabetes were recruited and randomized into two groups: (1) usual care (assessment only) and (2) the Mediterranean Lifestyle Program (MLP), a comprehensive lifestyle change intervention. The MLP yielded significant behavioral, psychosocial, and physiologic outcomes at 6 and 12 months post-intervention. In the proposed assessment-only "natural history" continuation, the longer-term (3- to 7-year) effects of the MLP will be examined using a variety of statistical approaches, including state-of-the-art mediational and latent growth modeling techniques. In addition, the potential for translating this program into the real world will be assessed using the RE-AIM evaluation framework, a cost-effectiveness analysis will be conducted, and dissemination of the intervention will begin if it proves cost-effective. This proposal represents the next logical step in this line of research, as it examines long-term maintenance of behavior change and lays the groundwork for translation of this successful intervention into practice. It will also provide important scientific and theoretical information about the patterns of maintenance/relapse among multiple risk factors, and about the relative importance of theoretical mediating variables (self-efficacy; problem-solving; peer and community support).

描述（由申请人提供）：冠状动脉疾病（CHD）是美国糖尿病后妇女妇女的死亡和功能限制的主要原因，糖尿病的风险尤为高，但与该人群的CHD研究非常有限。该提案探讨了多种行为变化（即饮食，体育锻炼和压力管理）的长期维持与冠心病风险有关的“自然历史”，以及理论上重要的中介变量对复发和维持的影响。拟议的研究是当前研究项目的延续，该项目已经显示出生活方式改变干预对减少2型糖尿病后妇女的行为冠心病风险因素的显着积极影响。这项研究依靠一个框架，该框架综合了社会认知，社会生态学和目标系统理论。在当前的研究中，招募了2型糖尿病的绝经后妇女并将其随机分为两组：（1）通常的护理（仅评估）和（2）地中海生活方式计划（MLP），这是一种全面的生活方式改变干预措施。在干预后6和12个月时，MLP产生了明显的行为，社会心理和生理结果。在拟议的仅评估的“自然历史”延续中，将使用多种统计方法（包括最先进的中介和潜在的增长建模技术）来检查MLP的长期（3至7年）影响。此外，将使用Re-AIM评估框架评估将该计划转化为现实世界的潜力，将进行成本效益分析，如果证明其成本效益，将开始进行干预措施的传播。该提案代表了这一研究方面的下一个逻辑步骤，因为它研究了行为改变的长期维护，并为将这种成功的干预措施转化为实践奠定了基础。它还将提供有关多个风险因素维护/复发模式的重要科学和理论信息，以及理论中介变量的相对重要性（自我效能；解决问题；同伴和社区支持）。