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An Innovative Multiphased Strategy to Recruit Underserved Adults into a Randomized Trial of a Community-Based Diabetes Risk Reduction Program

机译:一种创新的多阶段策略,将服务不足的成年人招募到基于社区的糖尿病风险降低计划的随机试验中

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摘要

Purpose: To conduct and evaluate a two-phased community-based approach to recruit lower socioeconomic status, minority, or Spanish-speaking adults at risk of developing diabetes to a randomized trial of a lifestyle intervention program delivered by a public health department. Design: Within geographic areas comprising our target population, 4 community organizations provided local space for conducting the study and program. Phase I—outreach in venues surrounding these organizations—included diabetes education, a short diabetes risk appraisal (DRA), and diabetes risk screening based on a fasting fingerstick glucose test. Phase II—trial recruitment—began concurrently for those found to be at risk of developing diabetes in Phase I by explaining the study, lifestyle program, and research process. Those interested and eligible enrolled in the 1-year study. Results: Over 2 years, approximately 5,110 individuals received diabetes education, 1,917 completed a DRA, and 1,164 were screened of which 641 (55%) had an elevated fingerstick result of ≥106 mg/dl. Of the study sampling frame—persons over age 25 at risk of developing diabetes (N = 544)—238 (43%) enrolled in the trial; of those who were study eligible (n = 427), 56% enrolled. In the final sample, mean age was 56 years (SD = 17), 78% were ethnic minorities, 32% were Spanish-speaking, and 15% had a high school education or less. Implications: Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors.
机译:目的:进行并评估一种基于社区的两阶段方法,以招募有可能患上糖尿病的较低社会经济地位,少数民​​族或讲西班牙语的成年人参加公共卫生部门实施的一项生活方式干预计划的随机试验。设计:在我们的目标人群所在的地理区域内,有4个社区组织为开展研究和计划提供了本地空间。第一阶段-在这些组织周围的场所进行的外展活动-包括糖尿病教育,简短的糖尿病风险评估(DRA)以及基于禁食指尖葡萄糖测试的糖尿病风险筛查。通过解释研究,生活方式计划和研究过程,第二阶段(试行招募)同时开始于第一阶段中发现有患糖尿病风险的人。那些有兴趣和资格的人参加了为期1年的研究。结果:在2年多的时间里,大约5,110个人接受了糖尿病教育,完成了1,917个人的DRA检查,并筛查了1,164个人,其中641(55%)的指尖结果≥106mg / dl。在研究样本框架中,年龄在25岁以上的人有患糖尿病的风险(N = 544),其中有238人(43%)参与了试验;在符合研究条件的人群中(n = 427),有56%的人报名参加。在最终样本中,平均年龄为56岁(SD = 17),少数民族为78%,讲西班牙语的为32%,高中或以下文化程度的为15%。启示:recruitment在进行研究募集之前提供糖尿病健康教育和筛查,可能有助于克服服务不足社区的研究参与障碍,从而帮助解决招募少数群体和老年人群参与研究的困难,特别是与慢性病危险因素有关的研究。

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