PDF(Pubmed)
Abstract：
Populations undergoing extensive and rapid socio-economic transitions including historically disadvantaged communities face an increased risk of type-2 diabetes (T2D). In recent years, sedentary behavior and physical inactivity have been considered modifiable determinants when developing primary prevention programs to reduce T2D incidence. Reunion Island is a French overseas department with an increasing T2D population and a high level of socio-economic inequality. The objectives of our study were to identify the individual, social, and environmental factors associated with sedentary behavior and physical inactivity among the Reunion Island adult population, and to highlight these findings in order to propose T2D primary prevention strategies aiming at alleviating local social inequalities in health (SIH). In 2021, we conducted a population-based cross-sectional telephone survey using random sampling. Participants included adults over 15 years old living in ordinary accommodation on Reunion Island (n = 2,010). Using a sequential approach, multinomial logistic regression model (explaining 3 profiles of interest: sedentary/inactive, sedentary/active, non-sedentary/inactive), and sampling-design weighted estimates, we found that 53.9% [95% confidence interval: 51.1 to 56.7%] of participants had sedentary behavior and 20.1% [95% CI: 17.8 to 22.5%] were inactive. Abandoning physical activity due to the COVID-19 pandemic (p<0.001), final secondary school diploma or above (p = 0.005), student as professional status (p≤0.005) and living in fewer poor neighborhoods located far from city centers (p = 0.030) were four conditions independently associated with sedentary/inactive and/or sedentary/active profiles. Based on these findings, to help reduce SIH, we used a typology of actions based on the underlying theoretical interventions including four main action categories: strengthening individuals (using person-based strategies), strengthening communities, improving living and working conditions, and promoting health-based macro-policies. Our findings suggest several directions for reducing lifestyle risk factors and enhancing T2D primary prevention programs targeting psychosocial, behavioral, and structural exposures.
摘要：
经历广泛而快速的社会经济转型的人群，包括历史上处于不利地位的社区，面临2型糖尿病（T2D）的风险增加。近年来,在制定降低T2D发病率的一级预防计划时，久坐行为和身体不活动被认为是可改变的决定因素。留尼汪岛是法国的海外部门，T2D人口不断增加，社会经济不平等程度很高。我们研究的目的是识别个体，社会,以及与留尼汪岛成年人口中久坐行为和缺乏身体活动相关的环境因素，并强调这些发现，以便提出旨在减轻当地社会健康不平等（SIH）的T2D一级预防策略。2021年，我们使用随机抽样进行了基于人群的横断面电话调查。参与者包括居住在留尼汪岛普通住所的15岁以上的成年人（n=2,010）。使用顺序方法，多项逻辑回归模型(解释了3个感兴趣的配置文件：久坐/不活跃，久坐/活跃，非久坐/不活跃)，和抽样设计加权估计，我们发现,53.9%[95%置信区间:51.1~56.7%]的参与者有久坐行为,20.1%[95%CI:17.8~22.5%]不活动.由于COVID-19大流行而放弃体力活动(p<0.001)，最终中学文凭或以上（p=0.005），学生作为专业地位(p≤0.005)和生活在远离市中心的贫困社区较少(p=0.030)是与久坐/不活动和/或久坐/活动状况独立相关的四个条件。基于这些发现,为了帮助减少SIH，我们使用了基于基础理论干预的行动类型，包括四个主要行动类别：加强个人（使用基于个人的策略），加强社区,改善生活和工作条件，促进基于健康的宏观政策。我们的研究结果为减少生活方式风险因素和加强T2D一级预防计划提供了几个方向，针对社会心理，行为，和结构性暴露。
