Effectiveness of a community intervention program on healthy lifestyles (PREDICOL) among adults with prediabetes in two Latin American cities: A quasi-experimental study

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM Primary Care Diabetes Pub Date : 2025-03-29 DOI:10.1016/j.pcd.2025.03.010

Yenifer Diaz Montes , Luis A. Anillo Arrieta , Juan Jose Espitia De La Hoz , Tania Acosta-Vergara , Jorge Acosta-Reyes , Karen C. Flórez Lozano , Rafael Tuesca Molina , Pablo Aschner , Sandra Rodríguez Acosta , Noël C. Barengo

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Abstract

Purpose

This study aimed to measure the impact of a community-based lifestyle modification intervention program on the Health-Related Quality of Life (HRQoL) of adults with prediabetes in two Latin American cities.

Methods

A quasi-experimental study was conducted with participants aged 30 and above in two Colombian cities between 2018 and 2022. The glycemic status of study participants was determined through the administration of an oral glucose tolerance test. Individuals exhibiting impaired glucose tolerance (IGT) were selected for inclusion in the intervention program. Of the 146 individuals identified with IGT, 91 completed the one-year intervention protocol. HRQoL was assessed utilizing the EQ-5D-3L questionnaire, both before and after the intervention. Logistic regression models were used to calculate the odds ratios (OR) and 95 % confidence intervals (CI), while classification models based on machine learning algorithms were utilized to identify factors associated with favorable changes in health-related quality of life (HRQoL).

Results

In Bogotá D.C., a significant improvement in HRQoL was documented (pre-intervention: 0.69 ± 0.17; post-intervention: 0.76 ± 0.16), attaining the threshold for clinically meaningful change (0.06). No changes in HRQoL were observed in the study participants. Logistic regression analysis revealed that the improvement in HRQoL was statistically significantly associated with sex (OR 8.75; 95 % CI 1.91–40.03), age (OR 11.61; 95 % CI 1.44–93.44), place of residence (OR 29.31; 95 % CI 5.26–163.54), and weight loss (OR 5.56; 95 % CI 1.15–26.76). According to the XGBoost model, return to normal glycemic status emerged as the most important variable for improvements in HRQoL.

Conclusion

Gender, age, place of residence, weight loss, and return to normoglycemic status were identified as significant predictors in lifestyle modification to improve HRQoL among participants at high risk of developing type 2 diabetes.

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拉丁美洲两个城市成人糖尿病前期健康生活方式社区干预项目（PREDICOL）的有效性：一项准实验研究

目的：本研究旨在衡量一项基于社区的生活方式调整干预计划对拉丁美洲两个城市的糖尿病前期成人健康相关生活质量（HRQoL）的影响：2018年至2022年期间，在哥伦比亚的两个城市对30岁及以上的参与者进行了一项准实验研究。研究参与者的血糖状况通过口服葡萄糖耐量测试来确定。筛选出糖耐量受损（IGT）的个体纳入干预计划。在确定的 146 名 IGT 患者中，有 91 人完成了为期一年的干预方案。利用 EQ-5D-3L 问卷对干预前后的 HRQoL 进行了评估。采用逻辑回归模型计算几率比（OR）和 95 % 的置信区间（CI），同时利用基于机器学习算法的分类模型确定与健康相关生活质量（HRQoL）的有利变化相关的因素：在哥伦比亚特区波哥大，HRQoL 有了显著改善（干预前：0.69 ± 0.17；干预后：0.76 ± 0.16），达到了有临床意义变化的临界值（0.06）。研究参与者的 HRQoL 没有发生变化。逻辑回归分析显示，HRQoL 的改善与性别（OR 8.75; 95 % CI 1.91-40.03）、年龄（OR 11.61; 95 % CI 1.44-93.44）、居住地（OR 29.31; 95 % CI 5.26-163.54）和体重减轻（OR 5.56; 95 % CI 1.15-26.76）有显著的统计学相关性。根据 XGBoost 模型，恢复正常血糖状态是改善 HRQoL 的最重要变量：结论：性别、年龄、居住地、体重减轻和血糖恢复正常被认为是改变生活方式以改善2型糖尿病高危人群HRQoL的重要预测因素。

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来源期刊

Primary Care Diabetes ENDOCRINOLOGY & METABOLISM-PRIMARY HEALTH CARE

CiteScore

5.00

自引率

3.40%

发文量

134

审稿时长

47 days

期刊介绍： The journal publishes original research articles and high quality reviews in the fields of clinical care, diabetes education, nutrition, health services, psychosocial research and epidemiology and other areas as far as is relevant for diabetology in a primary-care setting. The purpose of the journal is to encourage interdisciplinary research and discussion between all those who are involved in primary diabetes care on an international level. The Journal also publishes news and articles concerning the policies and activities of Primary Care Diabetes Europe and reflects the society''s aim of improving the care for people with diabetes mellitus within the primary-care setting.