Culturally Tailored Nutrition Therapy To Improve Dietary Adherence of Type 2 Diabetes Patients in Benin, Africa

根据文化量身定制的营养疗法可提高非洲贝宁 2 型糖尿病患者的饮食依从性

基本信息

批准号：
10706336
负责人：
Halimatou Alaofe
金额：
$ 14.77万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-21 至 2027-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10706336
关键词：
Address Adherence Adoption Africa African Area Award Behavior Behavior Therapy Behavioral Sciences Canada Carbohydrates Caring Chronic Disease Clinic Collaborations Collection Combined Modality Therapy Complement Counseling Country Data Death Rate Development Diabetes Mellitus Diet Diet Modification Dietitian Disease Epidemic Family Focus Groups Food Foundations Future Glycosylated Hemoglobin Glycosylated hemoglobin A Goals Grant Guidelines Health Health Food Health Personnel Healthcare Systems Hemoglobin concentration result Individual International Intervention Intervention Trial Interview Knowledge Linear Programming Low Income Population Low income Medical Nutrition Therapy Mentored Research Scientist Development Award Mentors Mentorship Menu Planning Methods Modeling Modification Monitor Morbidity - disease rate National Heart, Lung, and Blood Institute Non-Insulin-Dependent Diabetes Mellitus Nutrition Therapy Nutrition management Obesity Outcome Outcome Study Patients Persons Population Population Characteristics Positioning Attribute Prevalence Publications Qualitative Methods Randomized Randomized, Controlled Trials Recipe Recommendation Reporting Research Research Activity Research Design Research Methodology Resource-limited setting Risk Self Management Social Sciences Societies System Target Populations Testing Therapeutic Intervention Time Training Training Activity Translating Weight Woman Work adherence rate blood glucose regulation burden of illness cardiovascular risk factor care delivery career development cost effectiveness design diabetes control diabetes management dietary dietary adherence disability effectiveness testing efficacy evaluation empowerment glycemic control good diet high risk population improved innovation intervention cost intervention delivery men mortality nutrition nutrition education patient oriented research prevent programs protein intake recruit satisfaction stem usual care arm

项目摘要

ABSTRACT Effective medical nutrition therapy (MNT) is needed to stem the alarming increase in Type 2 diabetes (T2D) related morbidity and mortality in Benin, a French sub-Saharan African (SSA) country, where diabetes prevalence has quadrupled from 3% to 12.4% in the last decade, reaching 22% in some areas. The impact of the disease reaches beyond those living with the condition to their families, society, and the healthcare system, warranting strategic efforts to reduce its burden. Following a diet consistent with MNT guidelines is well- documented to help people with T2D achieve better glycemic control, reduce cardiovascular risks and prevent complications. However, despite these benefits, low adherence to dietary recommendations is consistently reported. The reasons include lack of nutrition knowledge, difficulty translating recommendations to practice, cultural acceptability of the diet, and access to healthy foods. Thus, culturally appropriate dietary recommendations based on locally available and accepted foods through guided counseling are key to improving dietary adherence rates among T2D patients in the country. The purpose of this International Research Scientist Development Award (K01) is to empower Dr. Halimatou Alaofè to develop a research program that integrates innovative approaches to nutrition care delivery to optimize diabetes control in low- income African populations. To achieve this goal, mentorship and training in this award are proposed to support: 1) additional training in menu planning and recipe development, social and behavioral sciences, and research methodologies; 2) protected time to conduct the planned patient-oriented research; and 3) the collection and publication of preliminary data to facilitate the next steps in the research program. Under the mentorship of Drs. John Ehiri and Waliou Amoussa Hounkpatin, as well as co-mentors and collaborators from the US and Benin, Dr. Alaofè plans to 1) adapt an existing MNT intervention that combines a 4-week local food menu plan based on the 4A framework (adequacy, acceptability, accessibility, and availability of foods) with individual counseling to meet the Benin nutrition therapy guidelines for T2D patients; 2) develop SmartMenu, a culturally tailored MNT for T2D patients using codesign methods; and 3) assess the feasibility, acceptability, and preliminary efficacy of SmartMenu for Benin patients with T2D. The anticipated outcome of this study is high-quality pilot data that will serve as the foundation for an R01 application to conduct a larger pragmatic randomized controlled trial to assess the intervention’s cost-effectiveness and sustainability. We hypothesize that a culturally tailored MNT combining individual counseling and menu plans that address dietary adherence barriers through the 4A framework will facilitate patient acceptance and adherence to MNT guidelines. If successful, this model could significantly improve nutrition care in resource-limited settings. The training and research activities delineated complement the candidate’s background in nutrition education and diet modification and will position her to contribute substantially to nutrition care delivery system change.

抽象的需要有效的医学营养疗法 (MNT) 来遏制 2 型糖尿病 (T2D) 的惊人增长贝宁是法属撒哈拉以南非洲 (SSA) 国家，糖尿病患者的相关发病率和死亡率过去十年中，患病率翻了两番，从 3% 增至 12.4%，在某些地区达到 22%。这种疾病不仅影响到患者的家庭、社会和医疗保健系统，遵循符合 MNT 指南的饮食习惯是有必要采取战略性措施来减轻其负担的。据记录可帮助 T2D 患者更好地控制血糖、降低心血管风险并预防然而，尽管有这些好处，但对饮食建议的遵守率始终较低。据报道，原因包括缺乏营养知识、难以将建议转化为实践、文化上可接受的饮食，以及获得健康食品的机会。因此，文化上适当的饮食。通过指导咨询根据当地可用和可接受的食物提出建议是关键提高该国 T2D 患者的饮食依从率本国际会议的目的。研究科学家发展奖（K01）旨在授权 Halimatou Alaofè 博士开展一项研究该计划整合了营养护理提供的创新方法，以优化低收入人群的糖尿病控制为了实现这一目标，该奖项的指导和培训旨在提高非洲人口的收入。支持：1) 菜单规划和食谱开发、社会和行为科学方面的额外培训，以及研究方法；2）有时间进行有计划的以患者为导向的研究；收集和发布初步数据，以促进研究计划的后续步骤。 John Ehiri 博士和 Waliou Amoussa Hounkpatin 博士以及来自的共同导师和合作者的指导在美国和贝宁，Alaofè 博士计划 1) 调整现有的 MNT 干预措施，结合为期 4 周的当地食物基于 4A 框架（食物的充足性、可接受性、可及性和可用性）的菜单计划个人咨询，以满足贝宁 T2D 患者营养治疗指南 2) 开发 SmartMenu，使用协同设计方法为 T2D 患者量身定制 MNT；3) 评估可行性、可接受性； SmartMenu 对贝宁 T2D 患者的初步疗效本研究的预期结果是。高质量的试点数据，将作为R01应用开展更大规模务实的基础随机对照试验评估干预措施的成本效益和可持续性。结合个人咨询和解决饮食依从性的菜单计划的文化定制 MNT 通过 4A 框架的障碍将促进患者接受和遵守 MNT 指南。如果成功，该模型可以显着改善资源有限环境中的营养护理。所描述的研究活动补充了候选人在营养教育和饮食方面的背景修改将使她能够为营养护理提供系统的变革做出重大贡献。