Meta Salud Diabetes for cardiovascular disease prevention in Mexico: a cluster-randomized behavioural clinical trial
| Autor: | Cecilia Rosales, Elizabeth Anderson, Maia Ingram, Benjamin Aceves, Tomas Nuño, Jill Guernsey de Zapien, María del Carmen Castro Vásquez, Jesus Eduardo Gonzalez-Fagoaga, Melanie L. Bell, Catalina A. Denman, Elsa Cornejo |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Epidemiology 030209 endocrinology & metabolism Type 2 diabetes Disease 03 medical and health sciences 0302 clinical medicine Quality of life Cardiovascular Disease Internal medicine Diabetes mellitus medicine Humans 030212 general & internal medicine Mexico Framingham Risk Score business.industry Infant General Medicine medicine.disease Confidence interval Clinical trial Distress Diabetes Mellitus Type 2 Cardiovascular Diseases Hypertension Quality of Life Female business |
| Zdroj: | Int J Epidemiol |
| ISSN: | 1464-3685 0300-5771 |
| DOI: | 10.1093/ije/dyab072 |
| Popis: | Background Healthy lifestyle interventions offered at points of care, including support groups, may improve chronic disease management, especially in low-resource populations. We assessed the effectiveness of an educational intervention in type 2 diabetes (T2D) support groups to reduce cardiovascular disease (CVD) risk. Methods We recruited 518 participants to a parallel, two-arm, cluster-randomized, behavioural clinical trial across 22 clinics in Sonora, Mexico, between August 2016 and October 2018. We delivered a 13-week secondary prevention intervention, Meta Salud Diabetes (MSD), within the structure of a support group (GAM: Grupo de Ayuda Mutua) in government-run (community) Health Centres (Centros de Salud). The primary study outcomes were difference in Framingham CVD risk scores and hypertension between intervention (GAM+MSD) and control (GAM usual care) arms at 3 and 12 months. Results CVD risk was 3.17% age-points lower in the MSD arm versus control at 3 months [95% confidence interval (CI): −5.60, −0.75, P = 0.013); at 12 months the difference was 2.13% age-points (95% CI: −4.60, 0.34, P = 0.088). There was no evidence of a difference in hypertension rates between arms. Diabetes distress was also lower at 3 and 12 months in the MSD arm. Post-hoc analyses showed greater CVD risk reduction among men than women and among participants with HbA1c Conclusions MSD contributed to a positive trend in reducing CVD risk in a low-resource setting. This study introduced an evidence-based curriculum that provides T2D self-management strategies for those with controlled T2D (i.e. HbA1c |
| Databáze: | OpenAIRE |
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