Randomized Trial of a Lifestyle Intervention for Urban Low-Income African Americans with Type 2 Diabetes.

Abstract:

BACKGROUND:African Americans suffer more than non-Hispanic whites from type 2 diabetes, but diabetes self-management education (DSME) has been less effective at improving glycemic control for African Americans. Our objective was to determine whether a novel, culturally tailored DSME intervention would result in sustained improvements in glycemic control in low-income African-American patients of public hospital clinics. RESEARCH DESIGN AND METHODS:This randomized controlled trial (n = 211) compared changes in hemoglobin A1c (A1c) at 6, 12, and 18 months between two arms: (1) Lifestyle Improvement through Food and Exercise (LIFE), a culturally tailored, 28-session community-based intervention, focused on diet and physical activity, and (2) a standard of care comparison group receiving two group DSME classes. Cluster-adjusted ANCOVA modeling was used to assess A1c changes from baseline to 6, 12, and 18 months, respectively, between arms. RESULTS:At 6 months, A1c decreased significantly more in the intervention group than the control group (- 0.76 vs - 0.21%, p = 0.03). However, by 12 and 18 months, the difference was no longer significant (12 months - 0.63 intervention vs - 0.45 control, p = 0.52). There was a decrease in A1c over 18 months in both the intervention (β = - 0.026, p = 0.003) and the comparison arm (β = - 0.018, p = 0.048) but no difference in trend (p = 0.472) between arms. The intervention group had greater improvements in nutrition knowledge (11.1 vs 6.0 point change, p = 0.002) and diet quality (4.0 vs - 0.5 point change, p = 0.018) while the comparison group had more participants with improved medication adherence (24% vs 10%, p < 0.05) at 12 months. CONCLUSIONS:The LIFE intervention resulted in improved nutrition knowledge and diet quality and the comparison intervention resulted in improved medication adherence. LIFE participants showed greater A1c reduction than standard of care at 6 months but the difference between groups was no longer significant at 12 and 18 months. NIH TRIAL REGISTRY NUMBER:NCT01901952.

journal_name

J Gen Intern Med

authors

Lynch EB,Mack L,Avery E,Wang Y,Dawar R,Richardson D,Keim K,Ventrelle J,Appelhans BM,Tahsin B,Fogelfeld L

doi

10.1007/s11606-019-04894-y

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

1174-1183

issue

7

eissn

0884-8734

issn

1525-1497

pii

10.1007/s11606-019-04894-y

journal_volume

34

pub_type

杂志文章,多中心研究,随机对照试验
  • Size misperception among overweight and obese families.

    abstract:BACKGROUND:Perception of body size is a key factor driving health behavior. Mothers directly influence children's nutritional and exercise behaviors. Mothers of ethnic minority groups and lower socioeconomic status are less likely to correctly identify young children as overweight or obese. Little evaluation has been d...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-014-3002-y

    authors: Paul TK,Sciacca RR,Bier M,Rodriguez J,Song S,Giardina EG

    更新日期:2015-01-01 00:00:00

  • Implementation of local guidelines for cost-effective management of hypertension. A trial of the firm system.

    abstract:OBJECTIVE:To evaluate the effects of an intensive intervention to implement guidelines for cost-effective management of hypertension on medication use and cost, blood pressure control, and other resource use. DESIGN:Retrospective cohort trial based on the Cleveland Veterans' Affairs Medical Center Firm System. SETTIN...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02600265

    authors: Aucott JN,Pelecanos E,Dombrowski R,Fuehrer SM,Laich J,Aron DC

    更新日期:1996-03-01 00:00:00

  • Frequency of mastalgia among women veterans. Association with psychiatric conditions and unexplained pain syndromes.

    abstract:OBJECTIVE:To determine the prevalence and frequency of mastalgia and its association with psychiatric conditions and unexplained pain syndromes. DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional mailed survey completed by 1,219 female veterans enrolled at the VA Puget Sound Health Care System in 1998. MEASUREMENTS:Br...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1111/j.1525-1497.2006.00378.x

    authors: Johnson KM,Bradley KA,Bush K,Gardella C,Dobie DJ,Laya MB

    更新日期:2006-03-01 00:00:00

  • The resident leaves the clinic: the effects of changing physicians on appointment-keeping behavior.

    abstract::To understand the effect that termination of an established physician-patient relationship has on patient attendance patterns in a medical clinic, appointment scheduling and patient attendance were measured for 210 patients before and after 11 senior resident physicians left the clinic. There was no significant change...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02599811

    authors: Brown JT,Fulkerson CC,Delong ER

    更新日期:1986-03-01 00:00:00

  • Optimal management strategies for HIV-infected patients who present with cough or dyspnea: a cost-effective analysis.

    abstract:OBJECTIVE:To determine the effectiveness and costs of alternative management strategies for patients infected with the human immunodeficiency virus (HIV) who present with pulmonary symptoms. DESIGN:Decision analysis comparing initial testing (arterial blood gas analysis, induced sputum analysis, or bronchoscopy with b...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审

    doi:10.1007/BF02598081

    authors: Freedberg KA,Tosteson AN,Cotton DJ,Goldman L

    更新日期:1992-05-01 00:00:00

  • The effect of comorbidity on use of thrombolysis or aspirin in patients with acute myocardial infarction eligible for treatment.

    abstract:OBJECTIVE:Growing evidence indicates that life-sustaining therapies for the treatment of acute myocardial infarction (AMI) are underused among patients eligible for therapy, including the elderly and women. We examined the effect of a patient's comorbidity burden on use of these highly effective therapies in eligible p...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1046/j.1525-1497.1997.12105.x

    authors: McLaughlin TJ,Soumerai SB,Willison DJ,Gurwitz JH,Gao X,Borbas C,Gobel F

    更新日期:1997-01-01 00:00:00

  • Can Internet-based continuing medical education improve physicians' skin cancer knowledge and skills?

    abstract::We sought to determine whether an Internet-based continuing medical education (CME) program could improve physician confidence, knowledge, and clinical skills in managing pigmented skin lesions. The CME program provided an interactive, customized learning experience and incorporated well-established guidelines for rec...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:

    authors: Harris JM,Salasche SJ,Harris RB

    更新日期:2001-01-01 00:00:00

  • Behavioral Treatment for Veterans with Obesity: 24-Month Weight Outcomes from the ASPIRE-VA Small Changes Randomized Trial.

    abstract:BACKGROUND:Small Changes (SC) is a weight management approach that demonstrated superior 12-month outcomes compared to the existing MOVE!® Weight Management Program at two Veterans Affairs (VA) sites. However, approaches are needed to help graduates of treatment continue to lose or maintain their weight over the longer...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s11606-017-3987-0

    authors: Lutes LD,Damschroder LJ,Masheb R,Kim HM,Gillon L,Holleman RG,Goodrich DE,Lowery JC,Janney C,Kirsh S,Richardson CR

    更新日期:2017-04-01 00:00:00

  • Why Aren't More Primary Care Residents Going into Primary Care? A Qualitative Study.

    abstract:BACKGROUND:Workforce projections indicate a potential shortage of up to 31,000 adult primary care providers by the year 2025. Approximately 80 % of internal medicine residents and nearly two-thirds of primary care internal medicine residents do not plan to have a career in primary care or general internal medicine. OB...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-016-3825-9

    authors: Long T,Chaiyachati K,Bosu O,Sircar S,Richards B,Garg M,McGarry K,Solomon S,Berman R,Curry L,Moriarty J,Huot S

    更新日期:2016-12-01 00:00:00

  • Rallying Against Racism: Hospitals Join the Fight for Racial Justice.

    abstract::This article highlights the timely situation that resident physicians, faculty, and staff are facing after the recent highly publicized murders of Black Americans and its impact on our healthcare communities. We discuss our experiences of how the hospital can serve as a meeting place for anti-racism, as well as how an...

    journal_title:Journal of general internal medicine

    pub_type: 社论

    doi:10.1007/s11606-020-06291-2

    authors: Okaka Y,AbdelHameid D,Olson RM,Kwarteng-Siaw M,Spanos N,Stone VE

    更新日期:2020-10-20 00:00:00

  • Treatment intensification and blood glucose control among hospitalized diabetic patients.

    abstract:BACKGROUND:Hyperglycemia is common among diabetic inpatients, and has been linked to adverse outcomes. However, antihyperglycemic treatment is seldom intensified in noncritical care patients, and the relationship between intensification frequency and glucose control is poorly understood. We evaluated the relationship b...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-007-0468-x

    authors: Matheny ME,Shubina M,Kimmel ZM,Pendergrass ML,Turchin A

    更新日期:2008-02-01 00:00:00

  • Tips for teachers of evidence-based medicine: making sense of decision analysis using a decision tree.

    abstract::Decision analysis is a tool that clinicians can use to choose an option that maximizes the overall net benefit to a patient. It is an explicit, quantitative, and systematic approach to decision making under conditions of uncertainty. In this article, we present two teaching tips aimed at helping clinical learners unde...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-009-0918-8

    authors: Lee A,Joynt GM,Ho AM,Keitz S,McGinn T,Wyer PC,EBM Teaching Scripts Working Group.

    更新日期:2009-05-01 00:00:00

  • The sociophysiology of caring in the doctor-patient relationship.

    abstract::The emotional investment required to construct a caring doctor-patient relationship can be justified on humane grounds. Can it also be justified as a direct physiologic intervention? Two lines of evidence point in this direction. People in an empathic relationship exhibit a correlation of indicators of autonomic activ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-1497.2002.10640.x

    authors: Adler HM

    更新日期:2002-11-01 00:00:00

  • Dense Breast Notification Laws, Education, and Women's Awareness and Knowledge of Breast Density: a Nationally Representative Survey.

    abstract:BACKGROUND:To date, 38 states have enacted dense breast notification (DBN) laws mandating that mammogram reports include language informing women of risks related to dense breast tissue. OBJECTIVE:Nationally representative survey to assess the association between residing in a state with a DBN law and women's awarenes...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-05590-7

    authors: Kyanko KA,Hoag J,Busch SH,Aminawung JA,Xu X,Richman IB,Gross CP

    更新日期:2020-07-01 00:00:00

  • Intern call structure and patient satisfaction.

    abstract::Our institution has instituted "short-call" and "nightfloat" systems to reduce the number of admissions to the traditional "long-call" housestaff. However, the nightfloat system introduces increased discontinuity to patient care, and interns may spend less time with short-call patients because they are nor required to...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1046/j.1525-1497.1997.012005308.x

    authors: Griffith CH 3rd,Wilson JF,Rich EC

    更新日期:1997-05-01 00:00:00

  • BRIEF REPORT: nutrition and weight loss information in a popular diet book: is it fact, fiction, or something in between?

    abstract:BACKGROUND/OBJECTIVE:Diet books dominate the New York Times Advice Best Seller list and consumers cite such books as an important source of nutrition information. However, the scientific support for nutrition claims presented as fact (nutrition facts) in diet books is not known. DESIGN/MEASUREMENTS:We assessed the qua...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1111/j.1525-1497.2006.00501.x

    authors: Goff SL,Foody JM,Inzucchi S,Katz D,Mayne ST,Krumholz HM

    更新日期:2006-07-01 00:00:00

  • Gender differences in aspirin use among adults with coronary heart disease in the United States.

    abstract:BACKGROUND:Aspirin reduces mortality for men and women with coronary heart disease (CHD). Previous research suggests women with acute coronary syndromes receive less aggressive care, including less frequent early administration of aspirin. The presence of gender differences in aspirin use for secondary prevention is le...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-007-0116-5

    authors: Opotowsky AR,McWilliams JM,Cannon CP

    更新日期:2007-01-01 00:00:00

  • Use of complementary and alternative medicine and self-rated health status: results from a national survey.

    abstract:BACKGROUND:Despite the absence of conclusive evidence of effectiveness, complementary and alternative medicine (CAM) is used by 4 of 10 adults in the US; little is known about the association between CAM use and health status. OBJECTIVE:To determine the relation between CAM use and self-reported health status and heal...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-010-1542-3

    authors: Nguyen LT,Davis RB,Kaptchuk TJ,Phillips RS

    更新日期:2011-04-01 00:00:00

  • The Role of Primary Care in Improving Access to Medication-Assisted Treatment for Rural Medicaid Enrollees with Opioid Use Disorder.

    abstract:BACKGROUND:The opioid epidemic has disproportionately affected rural areas, where a limited number of health care providers offer medication-assisted treatment (MAT), the mainstay of treatment for opioid use disorder (OUD). Rural residents with OUD may face multiple barriers to engagement in MAT including long travel d...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-04943-6

    authors: Cole ES,DiDomenico E,Cochran G,Gordon AJ,Gellad WF,Pringle J,Warwick J,Chang CH,Kim JY,Kmiec J,Kelley D,Donohue JM

    更新日期:2019-06-01 00:00:00

  • Evaluation of clinical innovation: a gray zone in the ethics of modern clinical practice?

    abstract:BACKGROUND:Various stakeholders can have differing opinions regarding ethical review when introducing new procedures with patients. OBJECTIVE:This pilot study examines the way in which Research Ethics Boards (REBs; Institutional Review Boards) and clinical biochemists (CBs; laboratory medicine specialists) differ in t...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-007-0410-2

    authors: Patenaude J,Grant AM,Xhignesse M,Leblanc F,Courteau J

    更新日期:2008-01-01 00:00:00

  • Prospective study of new participants in a community-based mind-body training program.

    abstract:BACKGROUND:Mind-body practices such as yoga are widely popular, but little is known about how such exercises impact health-related quality of life. OBJECTIVE:To measure changes in health-related quality of life associated with 3 months of mind-body training as practiced in community-based settings. DESIGN:Prospective...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1111/j.1525-1497.2004.30011.x

    authors: Lee SW,Mancuso CA,Charlson ME

    更新日期:2004-07-01 00:00:00

  • Coronary Artery Disease and Atherosclerotic Risk Factors in a Population-Based Study of Sudden Death.

    abstract:BACKGROUND:Sudden death is a public health problem with major impact on society. Coronary artery disease (CAD) is believed to underlie 60-80% of these deaths. While deaths from CAD have decreased in the recent decades, sudden death rates remain unacceptably high. OBJECTIVE:We aimed to assess the prevalence of CAD and ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-05486-6

    authors: Joodi G,Maradey JA,Bogle B,Mirzaei M,Sadaf MI,Pursell I,Henderson C,Mounsey JP,Simpson RJ Jr

    更新日期:2020-02-01 00:00:00

  • Do physicians spend more time with non-English-speaking patients?

    abstract:OBJECTIVE:To determine whether physicians at a general internal medicine clinic spend more time with non-English-speaking patients. DESIGN:A time-motion study comparing physician time spent with non-English-speaking patients and time spent with English-speaking patients during 5 months of observation. We also tested p...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1046/j.1525-1497.1999.00338.x

    authors: Tocher TM,Larson EB

    更新日期:1999-05-01 00:00:00

  • Changing the fourth-year medicine clerkship structure: a successful model for a teaching service without housestaff.

    abstract::The fourth-year medicine clerkship was restructured at one of four sites. Teams consisting of one attending physician and three students cared for eight new patients per week. The overall experience of the restructured clerkship was rated significantly more positively than the experiences at all other sites and the te...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02600292

    authors: Parenti CM

    更新日期:1993-01-01 00:00:00

  • Impact of prospective payment and discharge location on the outcome of hip fracture.

    abstract:OBJECTIVE:To determine the impact of prospective payment by diagnosis-related groups (DRGs) on length of stay in the hospital, ambulatory status, and level of post-hospital care needed for patients hospitalized with hip fracture. DESIGN:Retrospective chart review of a consecutive series of cases before and after the r...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/BF02599687

    authors: Gerety MB,Soderholm-Difatte V,Winograd CH

    更新日期:1989-09-01 00:00:00

  • "Serious and complex illness" in quality improvement and policy reform for end-of-life care.

    abstract::Americans are living longer - a mark of success in public health and medical care - but more will live the last few years with progressive illness and disability. The dominant conception of care delivery separates "aggressive" or life-extending care from "palliative" or death-accepting care, with an assumed "transitio...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1046/j.1525-1497.2001.90901.x

    authors: Lynn J,Forlini JH

    更新日期:2001-05-01 00:00:00

  • Time to Align Coverage with Evidence for Treatment of Back Pain.

    abstract::Despite improved knowledge about the benefits and harms of treatments for chronic back pain in the past several decades, there is a large and consequential mismatch between treatments found safe and effective and those routinely covered by health insurance. As a result, care for back pain has, if anything, deteriorate...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-019-05099-z

    authors: Cherkin DC,Deyo RA,Goldberg H

    更新日期:2019-09-01 00:00:00

  • Simulating Strategies for Improving Control of Hypertension Among Patients with Usual Source of Care in the United States: The Blood Pressure Control Model.

    abstract:BACKGROUND:Only half of hypertensive adults achieve blood pressure (BP) control in the United States, and it is unclear how BP control rates may be improved most effectively and efficiently at the population level. OBJECTIVE:We sought to compare the potential effects of system-wide isolated improvements in medication ...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-015-3231-8

    authors: Fontil V,Bibbins-Domingo K,Kazi DS,Sidney S,Coxson PG,Khanna R,Victor RG,Pletcher MJ

    更新日期:2015-08-01 00:00:00

  • Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis.

    abstract:BACKGROUND:Treatment decisions about menopause are predicated on a transient duration of vasomotor symptoms. However, evidence supporting a specific duration is weak. OBJECTIVE:To estimate the natural progression of vasomotor symptoms during the menopause transition by systematically compiling available evidence using...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章,meta分析

    doi:10.1007/s11606-008-0655-4

    authors: Politi MC,Schleinitz MD,Col NF

    更新日期:2008-09-01 00:00:00

  • Identifying key components for an effective case report poster: an observational study.

    abstract:BACKGROUND:Residents demonstrate scholarly activity by presenting posters at academic meetings. Although recommendations from national organizations are available, evidence identifying which components are most important is not. OBJECTIVE:To develop and test an evaluation tool to measure the quality of case report pos...

    journal_title:Journal of general internal medicine

    pub_type: 杂志文章

    doi:10.1007/s11606-008-0860-1

    authors: Willett LL,Paranjape A,Estrada C

    更新日期:2009-03-01 00:00:00