Meta-Analysis of Biobehavioral Determinants of Health Outcomes in Type 2 Diabetes

2 型糖尿病健康结果的生物行为决定因素的荟萃分析

• 批准号: 7765961
• 负责人: SHARON A BROWN
• 金额: $ 33.36万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-29 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7765961
• 关键词: Address; Adverse effects; Affect; Age; American; Anxiety; Behavioral; Body Weight decreased; Boxing; Caring; Cessation of life; Characteristics; Chronic Disease; Classification; Clinical; Clinical Trials; Code; Complications of Diabetes Mellitus; Control Locus; Coupled; Data; Data Reporting; Decision Making; Diabetes Mellitus; Diagnosis; Diet; Dietary intake; Disease; Dose; Economics; Education; Educational Status; Effectiveness; English Language; Epidemic; Failure; Fostering; Future; Gender; Generations; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Goals; Guidelines; Habits; Health; Health Care Costs; Health Professional; Health behavior; Health behavior change; Health behavior outcomes; Heterogeneity; Home environment; Hypertension; Individual; Insulin; Insulin-Dependent Diabetes Mellitus; International; Intervention; Kidney Failure; Knowledge; Label; Life; Life Style; Literature; Measurement; Measures; Mediating; Mediator of activation protein; Medical; Meta-Analysis; Metabolic Control; Methods; Modeling; Monitor; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Patients; Persons; Pharmaceutical Preparations; Pharmacologic Substance; Physical activity; Physiological; Play; Population; Prevalence; Procedures; Productivity; Psychological Factors; Publishing; Quality of life; Readiness; Reporting; Research; Research Design; Research Personnel; Risk; Role; Sample Size; Sampling; Self Care; Self Efficacy; Self Management; Series; Social support; Stress; Testing; Time; Treatment Protocols; biobehavior; blood glucose regulation; contextual factors; depression; diabetes control; diabetes management; disability; dosage; empowerment; evidence base; glucose monitor; glycemic control; health belief; improved; innovation; instrument; medication compliance; member; non-compliance; novel; predictive modeling; preference; premature; prevent; prospective; psychologic; public health relevance; racial and ethnic; recidivism; sedentary; self medication (prescribed); text searching

DESCRIPTION (provided by applicant): Large clinical trials demonstrated that glycemic control improves health outcomes in persons with type 2 diabetes, but fewer than 30% of these individuals achieve glycemic goals. To achieve glycemic control, individuals must adapt dietary preferences, increase physical activity, accurately adhere to prescribed medications, and self-monitor glucose levels several times per day. A large body of correlational and/or predictive research has explored intervening variables that may affect behavior change and health outcomes. This extensive literature has not been systematically reviewed nor synthesized. The proposed study will: 1) describe the research literature that examines associations among psychological factors, motivational factors, diabetes-related knowledge, and health behaviors and outcomes of weight loss, metabolic control, and quality of life in type 2 diabetes; and 2) using data synthesized from previously reported studies, test a series of predictive models that involve these variables. Meta-analytic and model- testing procedures will be used to synthesize both published and unpublished research data. Comprehensive literature search strategies will be used. Each primary study selected will involve: a) a sample of subjects diagnosed with type 2 diabetes; b) data reported between 1960 and the present; c) English language; d) weight loss, HbA1c, FBG, and/or quality of life measured as the criterion variable(s); e) a measure of at least one of the following predictors: psychological factors (stress, depression, anxiety), motivational factors (self-efficacy, empowerment/locus of control, readiness for change, health beliefs), diabetes-related knowledge, and/or behavioral factors (diet, physical activity, medication adherence, and self-monitoring); f) data in the form of correlation matrices among predictor and criterion variables or a simple correlation between at least one predictor and a criterion variable; and g) a minimum of 20 subjects. Rigorous procedures for establishing reliable and valid data extraction/coding will be employed. Established causal modeling procedures will be used to combine correlations across studies, test for heterogeneity of the correlation matrices, estimate the between-studies covariance components matrix, and estimate the random-effects of the common correlation matrix, along with either fixed- or random-effects estimation of the path coefficients of the predictive model, and the associated standard errors and significance tests. It is imperative to synthesize these studies to inform clinical guidelines so that clinicians can effectively address the growing global diabetes epidemic. PUBLIC HEALTH RELEVANCE: Despite recent technological and pharmaceutical advancements, fewer than thirty percent of individuals diagnosed with type 2 diabetes achieve glycemic goals. To achieve glycemic control, individuals must adapt dietary preferences, increase physical activity, accurately adhere to prescribed medications, and self- monitor glucose levels several times per day. The proposed study involves a systematic synthesis of the large body of research conducted on the psychological, motivational, and behavioral factors that need to be emphasized in diabetes interventions in order to improve diabetes health outcomes, particularly those related to glycemic control and quality of life. The information obtained will inform clinical guidelines so that clinicians can effectively address the growing global diabetes epidemic.

描述（由申请人提供）：大型临床试验表明，血糖控制可改善2型糖尿病患者的健康状况，但这些人中只有不到30％的人实现了血糖目标。为了获得血糖控制，个体必须适应饮食偏好，增加体育锻炼，准确地遵守处方药以及每天几次自我监测葡萄糖水平。大量的相关和/或预测性研究探索了可能影响行为变化和健康结果的中间变量。这种广泛的文献尚未系统地审查或合成。拟议的研究将：1）描述研究文献，研究了心理因素，动机因素，与糖尿病相关的知识以及健康行为以及体重减轻，代谢控制和2型糖尿病生活质量的结果； 2）使用先前报道的研究合成的数据，测试一系列涉及这些变量的预测模型。荟萃分析和模型测试程序将用于合成已发表和未发表的研究数据。将使用全面的文献搜索策略。所选的每项主要研究都将涉及：a）被诊断为2型糖尿病的受试者样本； b）在1960年至现在之间报告的数据； c）英语； d）减肥，HBA1C，FBG和/或生活质量，以标准变量测量； e）衡量以下至少一个预测因素之一：心理因素（压力，抑郁，焦虑），动机因素（自我效能，授权/授权/控制基因座，变革的准备，健康信念），与糖尿病相关的知识和/或行为因素和/或行为因素（饮食，体育锻炼，身体活动，药物依恋和自我监测）； f）预测变量和标准变量之间相关矩阵形式的数据或至少一个预测变量与标准变量之间的简单相关性； g）至少有20名受试者。将采用严格的建立可靠和有效数据提取/编码的程序。已建立的因果模型程序将用于结合跨研究的相关性，相关矩阵的异质性，估计研究间的协方差成分矩阵矩阵矩阵矩阵，并估算公共相关矩阵的随机效应，以及固定效率或随机测试的标准模型和相关模型的固定效率估计和相关模型的估算。必须合成这些研究以告知临床准则，以便临床医生可以有效解决日益增长的全球糖尿病流行。 公共卫生相关性：尽管最近的技术和药物进步，但诊断为2型糖尿病的人中，只有30％实现了血糖目标。为了获得血糖控制，个体必须适应饮食偏好，增加体育锻炼，准确地遵守处方药以及每天几次自我监测的葡萄糖水平。拟议的研究涉及对糖尿病干预中需要强调的心理，动机和行为因素进行的大量研究的系统综合，以改善糖尿病的健康结果，尤其是与血糖控制和生活质量有关的结果。获得的信息将为临床准则提供信息，以便临床医生可以有效解决日益增长的全球糖尿病流行。