Worksite Lifestyle Program for Reducing Diabetes and Cardiovascular Risk in India

印度降低糖尿病和心血管风险的工作场所生活方式计划

基本信息

批准号：
9306928
负责人：
Kabayam M Venkat Narayan
金额：
$ 68.59万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9306928
关键词：
Absenteeism Acute Adoption Adult Affect Age Anthropometry Asian Indian Behavior Behavior Therapy Blood Pressure Body Weight decreased Businesses Cardiovascular Diseases Caring Chronic Disease Communities Complications of Diabetes Mellitus Country Data Diabetes Mellitus Diabetes prevention Diet Dropout Eating Education Effectiveness Employee Environment Epidemic Exercise Family Focus Groups Food Glucose Glycosylated hemoglobin A Goals Health Health Educators Health Food Health Status Health care facility Health system Healthy Eating Human Resources Incidence India Individual Insurance International Intervention Interview Investments Life Expectancy Life Style Lipids Maintenance Measures Methods Modeling Participant Pharmaceutical Preparations Physical activity Plasma Population Populations at Risk Prediabetes syndrome Prevention Prevention program Productivity Program Acceptability Program Effectiveness Quality of life Randomized Controlled Trials Recommendation Reporting Research Research Personnel Resources Risk Factors Site Social support Stroke Structure Testing Text Time Training Translations Triglycerides Wages Weight Work Workplace base blood pressure reduction cardiometabolic risk cardiovascular disorder risk cardiovascular risk factor cost cost effective cost effectiveness diabetes control diabetes management diabetes risk disorder prevention effectiveness measure fasting glucose glycemic control good diet implementation trial improved improved outcome innovation intervention program lifestyle intervention lost work time member peer prevent programs public health relevance satisfaction scale up screening secondary outcome social success trial design

项目摘要

DESCRIPTION (provided by applicant): Asian Indians have high rates of diabetes, prediabetes and cardio metabolic risk factors. There is strong evidence that lifestyle change, particularly weight loss, increasing physical activity, and improving diet quality can prevent or delay diabetes, reduce cardiometabolic risk factors such as elevated glucose, plasma lipids, and blood pressure, and improve outcomes among individuals with diabetes. Implementing lifestyle change education and support at the worksite may be an effective and cost-effective method to deliver prevention in a way that is acceptable, accessible, and sustainable and overcomes barriers to lifestyle change (e.g., lack of time or resources). Building off previous work by the international study team, this study proposes implementing and evaluating in a pre-post design trial the acceptability, delivery, effectiveness, and cost- effectiveness of a worksite-based lifestyle improvement package including a peer-led lifestyle change education program augmented with changes in the worksite environment that promote social support, healthy eating and exercise. The lifestyle education program will include 2000 adults with prediabetes (HbA1c of 5.7- 6.4%) or unmedicated diabetes (HbA1c = 6.5% identified at screening) across eight diverse worksites in India (changes to the worksite environment will impact a much broader population of employees). A mixed methods approach will be used to evaluate implementation of the program. The study aims to measure: (1) Success of implementation in terms of program adoption (participation and changes in weight and diet and physical activity behaviors among lifestyle class participants); fidelity to the program (activities of study-affiliaed worksite staff; changes to the food options at the worksite canteen; management support for the program; and changes in the worksite environment); and program acceptability as reported by employees, managers, supervisors, and lifestyle education program participants and dropouts during in-depth, semi-structured interviews and focus group discussions. (2) Program effectiveness by evaluating the number of cardiometabolic risk goals reached for reductions in blood pressure, triglycerides, and HbA1c (the primary outcome) and through changes in secondary outcomes including rates of diabetes incidence and regression to normoglycemia and changes in anthropometry, lipids, and fasting glucose. (3) Value and return on the investment of the program for employers by assessing program costs, cost-effectiveness, and changes in staff productivity, absenteeism, health status, and quality of life. This project will deliver scientific innovations (lifestyle education programs with text message supports during maintenance) with social innovations (educated peer health educators delivering a program to a large at risk population) and business innovation (worksite stakeholder commitment and partnering researchers to help deliver the program with fidelity, improve the workplace health environment, and evaluate the model). If the program is shown to be feasible, acceptable, effective, and cost-effective at these worksites, the program could be disseminated to other worksites throughout India and elsewhere.

描述（由申请人提供）：亚裔印度人患糖尿病、糖尿病前期和心脏代谢危险因素的比例很高。有强有力的证据表明，生活方式的改变，特别是减肥、增加体力活动和改善饮食质量可以预防或延缓糖尿病、减少心脏代谢。在工作场所实施生活方式改变教育和支持可能是一种以可接受的方式提供预防的有效且具有成本效益的方法。无障碍，可持续，并克服生活方式改变的障碍（例如，缺乏时间或资源）。本研究建议在前期设计试验中实施和评估可接受性、交付、有效性和成本。 - 基于工作场所的生活方式改善方案的有效性，包括同伴主导的生活方式改变教育计划，并通过改变工作场所环境来促进社会支持、健康饮食和锻炼。该生活方式教育计划将包括 2000 名患有糖尿病前期 (HbA1c) 的成年人。印度 8 个不同工作场所的糖尿病（HbA1c = 6.5%）或未用药糖尿病（筛查时发现的 HbA1c = 6.5%）（工作场所环境的变化将影响更广泛的员工群体）。该研究旨在衡量：(1) 计划实施的成功程度（生活方式课程参与者的参与度以及体重、饮食和身体活动行为的变化）；（与研究相关的工作现场工作人员的活动；工作现场食堂食物选择的变化；管理人员对项目的支持；以及工作现场环境的变化）以及员工、经理、主管和生活方式教育项目参与者报告的项目可接受性； (2) 通过评估降低血压、甘油三酯和 HbA1c（主要结果）所达到的心脏代谢风险目标的数量来评估计划的有效性。以及通过次要结果的变化，包括糖尿病发病率和血糖正常的回归以及人体测量、血脂和空腹血糖的变化 (3) 通过评估计划成本、成本效益和对雇主的计划投资价值和回报。该项目将提供科学创新（在维护期间提供短信支持的生活方式教育计划）和社会创新（受过教育的同伴健康教育者向大量高危人群提供计划）。和业务创新（工作场所利益相关者承诺并与研究人员合作，帮助忠实地实施该计划，改善工作场所健康环境，并评估该模型）如果该计划在这些工作场所被证明是可行的、可接受的、有效的和具有成本效益的，则该计划。可以传播到印度各地和其他地方的其他工作场所。