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Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep.

Authors :
Wagner, Julie A.
Bermúdez-Millán, Angela
Buckley, Thomas E.
Buxton, Orfeu M.
Feinn, Richard S.
Kong, Sengly
Kuoch, Theanvy
Master, Lindsay
Scully, Mary F.
Source :
International Journal of Behavioral Nutrition & Physical Activity; 9/12/2023, Vol. 20 Issue 1, p1-11, 11p
Publication Year :
2023

Abstract

Background: Refugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions. Methods: Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months). Results: The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal education was 7.0 years. Individuals in the two treatment groups that received the EWS intervention significantly increased their brown rice consumption (p <.001, Cohen's d = 0.76) and their moderate-to-vigorous activity (p =.039, d = 0.32). No intervention changed sleep duration, timing, efficiency or wake after sleep onset. Across groups, individuals who increased brown rice consumption, increased vigorous activity and decreased total sleep time variability showed decreased HbA1c, with small effect sizes. Conclusions: CHEs may improve nutrition and physical activity in refugees with depression but more intensive interventions may be required to impact sleep. Improvements in all three behaviors appear to be associated with HbA1c lowering Trial registration: ClinicalTrials.gov identifier NCT02502929. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14795868
Volume :
20
Issue :
1
Database :
Complementary Index
Journal :
International Journal of Behavioral Nutrition & Physical Activity
Publication Type :
Academic Journal
Accession number :
171897774
Full Text :
https://doi.org/10.1186/s12966-023-01509-y