IMPROVING CONTROL WITH ACTIVITY AND NUTRITION

通过活动和营养改善控制

• 批准号: 8167149
• 负责人: Anne Armour Wolf
• 金额: $ 0.13万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8167149
• 关键词: American; Behavior; Body Weight decreased; Caring; Case Management; Complement; Computer Retrieval of Information on Scientific Projects Database; Diabetic Angiopathies; Evaluation; Funding; Glycosylated hemoglobin A; Grant; Habits; Health Planning; Health system; Healthcare; Institution; Intervention; Lead; Life Style; Lipids; Maintenance; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome Study; Participant; Patients; Physicians; Primary Health Care; Process; Quality of life; Randomized; Randomized Clinical Trials; Research; Research Personnel; Resources; Risk Factors; Source; Translations; United States National Institutes of Health; Universities; Virginia; arm; base; behavior change; design; diet and exercise; disorder risk; glycemic control; health care service utilization; improved; lifestyle intervention; macrovascular disease; nutrition; prevent; theories; translational study

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Despite strong evidence that diet, exercise, and weight loss can lead to clinically important improvement in risk factors for both micro- and macrovascular disease in people with type 2 diabetes, barriers at the patient, clinician, and health system level have prevented the translation of these findings into practice. The proposed translational study, Improving Control with Activity and Nutrition (ICAN) is a partnership between the University of Virginia and Southern Health Systems, a health plan with enrollees throughout Virginia, to demonstrate that clinically proven lifestyle interventions can be implemented and maintained in settings more typical of those in which a majority of Americans receive care. The proposed study is a two-arm randomized clinical trial of the ability of lifestyle case management interventions to improve glycemic control, reduce macro- and microvascular disease risk factors, support health-promoting diet and exercise habits, improve quality of life, and reduce the use of high intensity health care venues, among health plan enrollees with type 2 diabetes who are obese. Participants will be randomly assigned to one of two conditions: 1) the lifestyle case management group, which will receive one year of theory-based and demonstrated intensive lifestyle intervention, followed by 30 months of lifestyle case management designed to help participants maintain or enhance their diet and exercise habits; 2) the lifestyle intervention group, which will receive the same intense year-long intervention, but will not receive ongoing guidance after the year (the "lifestyle intervention" group). Both groups will be followed for 42 months. Primary study outcomes are glycemic control (HbA1c), lipid profiles, diet and exercise behavior, and health care utilization; a process evaluation will focus on acceptance of the project by participants and physicians, as well as mechanisms through which the intervention influences behavior change. We hypothesize that the lifestyle case management intervention will result in improved glycemic control and risk factor status, greater maintenance of changes in diet and exercise, and decreased health care utilization, compared to the lifestyle intervention group. The project complements existing primary care for type 2 diabetes; patients will continue to be treated by their regular physicians during the trial. Results will be immediately applicable to a majority of health plans and practices in the U.S.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 尽管有强有力的证据表明饮食、运动和减肥可以使 2 型糖尿病患者的微血管疾病和大血管疾病的危险因素得到临床上重要的改善，但患者、临床医生和卫生系统层面的障碍阻碍了这些因素的转化。将这些发现付诸实践。 拟议的转化研究“通过活动和营养改善控制”(ICAN) 是弗吉尼亚大学和南方卫生系统之间的合作伙伴关系，这是一项面向整个弗吉尼亚州参与者的健康计划，旨在证明经过临床验证的生活方式干预措施可以在更多环境中实施和维持。大多数美国人接受护理的典型情况。 拟议的研究是一项双组随机临床试验，旨在研究生活方式案例管理干预措施改善血糖控制、减少大血管和微血管疾病危险因素、支持促进健康的饮食和运动习惯、改善生活质量以及减少糖尿病的能力。肥胖的 2 型糖尿病健康计划参与者使用高强度医疗保健场所。参与者将被随机分配到以下两种情况之一：1）生活方式案例管理组，该组将接受为期一年的基于理论和经过验证的强化生活方式干预，然后是为期 30 个月的生活方式案例管理，旨在帮助参与者维持或增强他们的生活习惯。饮食和运动习惯； 2）生活方式干预组，将接受为期一年的同样强度的干预，但年后不会接受持续的指导（“生活方式干预”组）。 两组都将被跟踪 42 个月。 主要研究结果是血糖控制 (HbA1c)、血脂、饮食和运动行为以及医疗保健利用；过程评估将侧重于参与者和医生对项目的接受程度，以及干预影响行为改变的机制。 我们假设，与生活方式干预组相比，生活方式病例管理干预将改善血糖控制和危险因素状态，更好地维持饮食和运动的改变，并减少医疗保健的利用率。该项目补充了现有的 2 型糖尿病初级保健；在试验期间，患者将继续接受其常规医生的治疗。 结果将立即适用于美国的大多数健康计划和实践。