Strong in Body and Spirit
Lifestyle intervention for Native American adults with diabetes in New Mexico
- Susan S. Gilliland, PHD1,
- Stanley P. Azen, PHD1,
- Georgia E. Perez2 and
- Janette S. Carter, MD2,3
- 1Department of Preventive Medicine, University of Southern California, Los Angeles, California
- 2Department of Medicine, University of New Mexico, Albuquerque, New Mexico; and the New Mexico Veterans Affairs Health Care System, Albuquerque, New Mexico
Abstract
OBJECTIVE—To determine the effects of a culturally appropriate diabetes lifestyle intervention for Native Americans on risk factors for complications of diabetes.
RESEARCH DESIGN AND METHODS—A nonrandomized, community-based diabetes intervention trial was conducted in three Native American sites in New Mexico from 1993–1997. Participants were assigned to intervention or control based on community of residence. Intervention sessions were held ∼6 weeks apart over ∼10 months. The intervention was delivered in site A in family and friends (FF) groups (n = 32); site B received the same intervention in one-on-one (OO) appointments (n = 39); and site C received usual medical care (UC) (n = 33) (total participants, n = 104). Primary change in HbA1c level was assessed at 1 year.
RESULTS—Adjusted mean change in HbA1c value varied significantly across the three arms at 1 year (P = 0.05). The UC arm showed a statistically significant increase in adjusted mean HbA1c change (1.2%, P = 0.001), whereas both intervention arms showed a small nonsignificant (P > 0.05) increase in the adjusted mean change (0.5% and 0.2% for FF and OO arms, respectively). The increase was statistically significantly smaller in the combined intervention arms (0.4%) compared with the UC arm (1.2%, P = 0.02).
CONCLUSIONS—Lifestyle intervention has the potential to substantially reduce microvascular complications, mortality, and health care utilization and costs if the change is sustained over time.
Footnotes
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Address correspondence and reprint requests to Susan S. Gilliland, PhD, University of Southern California, Keck School of Medicine, Department of Preventive Medicine, 1540 Alcazar St., CHP 218, Los Angeles, CA 90033-9010. E-mail: sgillila{at}usc.edu.
Received for publication 4 May 2001 and accepted in revised form 7 August 2001.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
