基于mHealth的社区卫生工作者反循环的实施和评估,用于患有糖尿病和患糖尿病风险的西班牙裔
Elizabeth M Vaughan1,2, Victor J Cardenas3, Wenyaw Chan4
1Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, TX, USA. emvaugha@utmb.edu.
Journal of general internal medicine
|October 6, 2023
概括
一个涉及参与者,社区卫生工作者 (CHW) 和临床医生的移动健康 (mHealth) 反循环改善了2型糖尿病护理. 这种干预成功地解决了参与者问题,并加强了血糖控制,与通常的护理不同.
科学领域:
- 公共卫生 公共卫生
- 数字健康数字健康
- 糖尿病管理 糖尿病管理
背景情况:
- 在服务不足的社区,糖尿病护理面临着重要的可访问性和沟通障碍.
- 移动卫生 (mHealth) 和社区卫生工作者 (CHW) 提供潜在的解决方案,但需要严格的评估.
- 这项研究解决了评估糖尿病护理的综合mHealth和CHW模型的需要.
研究的目的:
- 评估一个新的基于mHealth的反循环,在现实环境中连接参与者,CHW和临床医生.
- 评估这种干预措施的可行性和有效性,以改善低收入,无保险的西班牙裔个人的糖尿病管理.
主要方法:
- 一项准实验性可行性研究,将干预组与通常护理 (UC) 组进行比较.
- 134名低收入,没有保险的西班牙裔参与者患有2型糖尿病或患有2型糖尿病风险.
- 该干预涉及15个月的mHealth反循环和每月通过YouTube进行糖尿病教育.
主要成果:
- 干预组显示HbA1c水平显著改善 (-0.51%,p=0.03),而UC组没有.
- 医疗保健工作室发现并解决了433名参与者报告的问题中的91.9%,主要与供应,身体健康和药物获取有关.
- 在UC组经历了扩张性血压 (DBP) 的恶化,而处于风险的UC参与者显示HbA1c,缩性血压 (SBP) 和DBP的恶化.
结论:
- 基于mHealth的参与者-CHW-临床医生反循环与改善的血糖控制 (HbA1c) 和有效的问题解决有关.
- 常规护理组,特别是糖尿病风险组,经历了临床恶化,表明潜在的疾病进展和并发症.
- 这种综合模型显示了改善弱势群体糖尿病护理的前景.
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