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- Title
Evaluation of a Behavioral Intervention With Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes.
- Authors
Ahn, SangNam; Lee, Joonhyung; Bartlett-Prescott, Jenny; Carson, Lisa; Post, Lindsey; Ward, Kenneth D.
- Abstract
<bold>Purpose: </bold>To examine the effects of a community-based behavioral intervention with multiple components on health outcomes among low-income and uninsured adults who were obese and had diabetes and treated in a "real-world" setting.<bold>Design: </bold>A longitudinal design with a retrospective comparison group was used to examine the ability of a health promotion program to improve body mass index (BMI) and hemoglobin A1c (HbA1c) among 87 treatment group and 62 comparison group participants.<bold>Setting: </bold>Urban/metropolitan city in the United States.<bold>Intervention: </bold>A community-based behavioral intervention with 3 components including health-coach visits, registered dietitian visits, and exercise consultations delivered over 12 months.<bold>Measures: </bold>Biometric measurements were collected at baseline, 3, 6, 9, 12, and 18 months, whereas self-reported measurements were collected at baseline, 6 months, and 12 months.<bold>Analysis: </bold>Linear mixed models with participant-level random intercepts were fitted for BMI and HbA1c.<bold>Results: </bold>The treatment group demonstrated reductions in BMI (percentage change = -2.1%, P < .001) and HbA1c (-0.6%, P < .001) as well as improvement in diabetes knowledge (+5.4%, P = .025), whereas the comparison group did not show any improvements in biometric measures. Dietitian visits were the most effective treatment component to reduce HbA1c (coefficient = -0.08, P = .025).<bold>Conclusion: </bold>Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.
- Subjects
UNITED States; HEALTH of adults; OVERWEIGHT persons; PEOPLE with diabetes; BEHAVIORAL assessment; BODY mass index; HEALTH promotion; TYPE 2 diabetes treatment; OBESITY &; psychology; OBESITY treatment; TYPE 2 diabetes &; psychology; ANTHROPOMETRY; BEHAVIOR therapy; BLOOD pressure; COMPARATIVE studies; HEALTH attitudes; HEALTH status indicators; LIPIDS; LONGITUDINAL method; RESEARCH methodology; MEDICAL care research; MEDICAL cooperation; MENTAL health; RESEARCH; SOCIOECONOMIC factors; EVALUATION research; RETROSPECTIVE studies
- Publication
American Journal of Health Promotion, 2018, Vol 32, Issue 2, p409
- ISSN
0890-1171
- Publication type
journal article
- DOI
10.1177/0890117117696250