在印度尼西亚COVID-19大流行期间使用混合方法改善社区健康生活方式行为:机遇与挑战

Hotma Rumahorbo, Atin Karjatin, Wiwin Wiryanti, B. Sakti
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摘要

背景:COVID - 19大流行对印度尼西亚的公共卫生服务构成挑战,因为社区预防糖尿病的各种重点卫生服务尚未实施。肥胖、缺乏体育锻炼、少吃蔬菜和/或水果等糖尿病风险因素也有所增加。SESAMA (Segitiga Kerjasama/三角合作)模式是一种糖尿病控制模式,其实施直接在社区进行,但在COVID-19大流行期间,它无法完全实施,因此混合方法成为对实施策略的修改。本研究旨在探讨SESAMA模型是否可以使用混合方法实现。方法:对4个目标村的所有18岁以上人群进行调查,并进行空腹血糖筛查和体重测量。该调查产生了许多符合肥胖标准的受访者,他们有或没有糖尿病前期,并给予SESAMA干预模型。结果:糖尿病前期患者人数从148人减少到105人(29.05%)。伴有肥胖症的前驱糖尿病患者的死亡率也有所下降。从108例伴有3级肥胖的糖尿病前期患者中,14人减少到3人(78.57%);2级从12人减少到9人(25%),1级从82人增加到83人,正常体重从40人增加到53人。结论:采用混合方法对COVID-19大流行期间的前驱糖尿病患者实施SESAMA模型显示,前驱糖尿病患者的比例有所下降。糖尿病前期患者的肥胖比例也有所下降。在大流行期间,SESAMA模型可以通过保持严格的卫生协议的应用和优化与社区各利益攸关方的合作,使用混合方法来实施。
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Use of Hybrid Methods in Improving Community Healthy Lifestyle Behavior during the COVID-19 Pandemic in Indonesia: Opportunities and Challenges
BACKGROUND: The COVID 19 pandemic is a challenge for public health services in Indonesia because various priority health services for diabetes prevention in the community have not been implemented. Diabetes risk factors such as obesity, lack of physical exercise, and eating fewer vegetables and/or fruit also increased. The SESAMA (Segitiga Kerjasama/Triangle of cooperation) model is a Diabetes control model whose implementation is carried out directly in the community but during the COVID-19 pandemic, it could not be fully implemented so the hybrid method became a modification of the implemented strategy. This study aims to find out whether the SESAMA model can be implemented using the hybrid method. METHODS: The study was conducted by a survey to all people aged > 18 years in 4 target villages, who participated in fasting blood glucose screening and body weight measurements. The survey produced a number of respondents who met the criteria for obesity with or without prediabetes and were given the SESAMA model of intervention.   RESULTS: There was a decrease in the number of people with prediabetes from 148 people to 105 people (29.05%). Prediabetes with obesity also experienced a reduction. From 108 people with prediabetes with grade 3 obesity, 14 people were reduced to 3 people (78.57%); for grade 2 as many as 12 people were reduced to 9 people (25%) and for grade 1 as many as 82 people increased to 83 people and normal weight increased from 40 people to 53 people. CONCLUSIONS: Implementation of the SESAMA Model for people with Prediabetes during the COVID-19 Pandemic which was carried out using the hybrid method showed a decrease in the proportion of people with prediabetes. The proportion of obesity in people with prediabetes has also decreased. The SESAMA model during a pandemic can be implemented using the hybrid method, by maintaining the application of strict health protocols and optimizing cooperation with various stakeholders in the community.
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