Dissemination of a Diabetes Prevention Program among Medicare Eligible Retirees

在符合医疗保险资格的退休人员中传播糖尿病预防计划

基本信息

批准号：
8496775
负责人：
Elizabeth Mary Venditti
金额：
$ 50.45万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-07-01 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8496775
关键词：
Address Adherence Adult Age Age-Years Aging Behavioral Benchmarking Blood Pressure Body Weight Body Weight decreased Clinical Research Cost Control Data Development Diabetes Mellitus Educational Curriculum Effectiveness Elderly Enrollment Epidemiology Equilibrium Future Gait Glucose Goals Health Health Benefit Healthcare Incidence Individual Insurance Carriers International Intervention Life Style Lipids Measures Medical Medicare Metabolic Monitor Newsletter Non-Insulin-Dependent Diabetes Mellitus Obesity Outcome Overweight Participant Patient Self-Report Persons Pharmaceutical Preparations Physical Function Physical activity Population Prevention program Process Protocols documentation Public Health Randomized Records Recruitment Activity Report (document)Reporting Research Research Infrastructure Resources Risk Risk Factors Risk Reduction Role Sampling Speed Telephone Time Translations Treatment outcome Universities Weight age group aged base blood lipid cohort community setting cost design diabetes prevention program diabetes risk effective therapy eligible participant evidence base follow-up grasp health care service utilization health related quality of life high risk impaired glucose tolerance improved innovation intervention program lifestyle intervention meetings non-diabetic novel physical conditioning physical functional ability prevent programs retiree satisfaction screening treatment duration young adult

项目摘要

DESCRIPTION (provided by applicant): There is substantial evidence that overweight and obesity during late life (¿ 65 years of age) confers significant risk for type 2 diabetes and co-morbid conditions. Thus, there is growing concern about the public health consequences of increased incidence of type 2 diabetes in an aging U.S. population. Studies with high risk samples have shown that lifestyle interventions significantly reduce diabetes risk and that elders are particularly responsive, showing better weight loss and lower rates of diabetes development in comparison to younger individuals. However, although there have been program dissemination studies with mixed-age adult cohorts, few studies have focused specifically on persons ¿ 65 years of age or addressed the challenges of identifying workable platforms for delivering prevention programs to older adults. This application is based on the premise that offering an evidence-based lifestyle intervention to reduce risk for type 2 diabetes to retirees during the annual Medicare enrollment process presents an innovative, practical opportunity to reach eligible, high-risk adults. If shown to be feasible and effective, this program has strong potential for public health impact and medical cost-containment. Further, although clinical studies have emphasized the importance of continued contact over time in helping individuals extend the benefits of lifestyle interventions, there are no dissemination studies of which we are aware that have systematically documented the impact of continued monthly contacts after the initial intervention period. Thus, the overall aims of this application are to: 1. examine the feasibility and effectiveness of implementing the Group Lifestyle Balance 12-session program (GLB-12), an evidence- supported prevention program to mitigate diabetes risk, as part of the Medicare benefit offered to high risk retirees at a large public university, and; 2. evaluate the utility of continued telephone contact in enhancing treatment outcome over a 24-month period. Eligible participants will be 320 non-diabetic adults, aged 65-80, with a BMI ¿ 27 and at least one additional cardio-metabolic risk factor. All participants will receive the GLB-12 and then will be randomized to one of two continued-contact protocols for the remaining one year of intervention, 10-sessions of continued small group contact by telephone (GLB-12 plus 10TC) or a newsletter control condition (GLB-12 plus NC). Program feasibility will be assessed by reporting enrollment, adherence and session completion rates, and satisfaction ratings in this delivery context. Effectiveness of the GLB-12 will be documented by reporting the proportion of participants meeting ¿ 5% weight loss, a commonly accepted benchmark in translation studies known to be associated with favorable cardio-metabolic outcomes at month 4. It also is hypothesized that GLB-12 plus 10TC, when compared to GLB-12 plus NC will be associated with more favorable anthropometric (weight, waist), cardio-metabolic (glucose, blood pressure, lipid), physical function (grip strength, balance, gait speed) and health related quality of life outcomes at months 12 and 24. Finally, exploratory analyses will document program costs and program impact on medical utilization.

描述（由适用提供）：有大量证据表明，晚期（65岁）的超重和肥胖症赋予了2型糖尿病和合并症状况的重大风险。这是对美国老年人群中2型糖尿病事件增加的公共卫生后果的越来越关注。具有高风险样本的研究表明，生活方式干预措施可显着降低糖尿病的风险，而长者特别敏感，与年轻人相比，体重减轻更好，糖尿病发育率降低。但是，尽管已经进行了混合成年人群的计划传播研究，但很少有研究专门针对65岁的人，或者解决了确定可行平台以向老年人提供预防计划的挑战。该申请基于这样的前提：在年度医疗保险注册过程中，提供基于证据的生活方式干预以降低2型糖尿病的退休人员的风险，这是一个创新的，实用的机会，可以吸引合格的高风险成年人。如果证明是可行和有效的，则该计划对公共卫生影响和医疗成本控制具有强大的潜力。此外，尽管临床研究强调了随着时间的推移，持续接触在帮助个人扩大生活方式干预措施的好处的重要性，但我们知道，我们知道，在最初的干预期后，我们知道这些研究已经系统地记录了持续每月接触的影响。这是该应用程序的总体目的是：1。检查实施团体生活方式平衡12会议计划（GLB-12）的可行性和有效性，这是一种循证支持的预防计划，以减轻糖尿病的风险，作为为高风险退休人员提供的医疗保险福利的一部分，以及； 2。在24个月内增强治疗结果，评估持续电话接触的效用。符合条件的参与者将是320名非糖尿病成年人，年龄为65-80岁，BMI€27和至少一个额外的心脏代谢风险因素。所有参与者将收到GLB-12，然后将在剩余的一年干预措施中，随机分配到两个持续接触方案之一，通过电话（GLB-12加10TC）或新闻通讯控制条件（GLB-12加上NC）进行了10次持续小组接触。计划可行性将通过报告入学率，依从性和会话完成率以及在此交付环境中的满意度评级来评估。 GLB-12的有效性将通过报告与5％的体重减轻5％的参与者的比例进行记录，这是翻译研究中通常接受的基准标准，该基准与第4个月的有利心形代谢结果相关。当GLB-12 Plus 10tc（与GLB-12 Plus NC相比，glb-12 plus NC）与a flocy a a flowerosement相关时，它也被认为是glb-12 plus 10tc。血压，脂质），身体功能（抓地力，平衡，敏捷速度）和与健康相关的生活质量在第12和24月的生活质量。最后，探索性分析将记录计划成本和计划对医疗利用的影响。