基于信息化平台的社区人群糖尿病干预模式的构建和评价  

Establishment and evaluation of a behavior intervention model for diabetes in community population based on the information platform

作　　者：莫明露 段明香 王太武[1] 焦惠艳 熊鸿燕[1] 

机构地区：[1]第三军医大学军事预防医学院军队流行病学教研室,重庆400038 [2]重庆市双碑社区卫生服务中心,重庆400032

出　　处：《第三军医大学学报》2017年第10期1056-1062,共7页Journal of Third Military Medical University

基　　金：重庆市卫生和计划生育委员会资助项目(20141027)~~

摘　　要：目的以社区糖尿病前期人群为对象,以充分利用社会资源为目标,构建经济、适用的糖尿病行为干预新型模式。方法通过系统分析和德尔菲法建立针对糖尿病前期人群的行为干预项目;根据流行病学实验的方法,在重庆主城区慢病控制试点社区开展干预试验。将522例糖尿病前期患者随机分为试验组和对照组,根据"知-信-行"的行为干预理论,试验组对象在接受社区常规健康管理服务的基础上,增加新型行为干预项目,同时接受定期社区现场活动和信息化平台交流活动;对照组对象只接受常规社区健康管理。干预实施后,定期观察试验组对象行为变化情况;半年后比较两组的行为执行情况、糖尿病的发病率、身体测量指标和实验室检测指标的变化情况。结果从干预试验实施后的第4~24周,试验组各健康行为改变率均有不同程度的增加;半年后,试验组与对照组相比,除穴位按摩和以步代车行为外,所有要求健康行为执行强度和行为养成比例显著增加;试验组的糖尿病发病率为4.51%,对照组的糖尿病发病率为7.58%,两组糖尿病发病率差异无统计学意义(P>0.05);与对照组相比,试验组BMI降低显著,但其他指标,如腰围、血压、血糖和糖化血红蛋白等变化差异无统计学意义(P>0.05)。结论在现有社区慢病管理的基础上构建的糖尿病新型行为干预模式,从多个环节促进被干预者行为改变,有助于试验对象建立健康行为,提高研究对象的依从性,其在短期内已显示出降低体质量指数的效果。Objective To establish an economic and practical behavior intervention model for prediabetic community population. Methods Systematic analysis and Delphi methods were used to formulate the items in the behavior intervention model for diabetes. This intervention model was tested in communities in the urban area of Chongqing selected for trials of chronic non-communicable disease control. A total of 522 prediabetic subjects were recruited, who were randomized into intervention group and control group. Based on the knowledge-attitude-behavior model, the subjects in the intervention group were provided with new behavior interventions in addition to routine community health management services with regular community activities and communication through the information platform, while the control subjects were given access only to conventional community health management services. During the intervention, the behavioral changes of the subjects were assessed regularly, and 6 months later, the behavioral compliance, incidence of diabetes, and changes in body measurements and laboratory test results were compared between the 2 groups. Results From the 4th to the 24th week after commencement of the intervention, the subjects in the intervention group showed a significantly increased rates of health behavior changes. Six months later, the incidence of diabetes was 4.51% in the intervention group and 7.58% in the control group, showing no significant difference between the 2 groups. A more significant decrease in BMI was noted in the intervention group, but the changes in waist circumference, blood pressure, blood glucose level and glycated hemoglobin were comparable between the two groups. Conclusion This behavior intervention model, in addition to the existing chronic disease management program, can promote behavior changes and compliance of pre-diabetic individuals to establish healthy behaviors. The short-term results of intervention using this model have shown its effectiveness in reducing BMI of the participants.

关 键 词：社区 糖尿病 新型行为干预模式 

分 类 号：R181.38[医药卫生—流行病学] R492[医药卫生—公共卫生与预防医学]