躺下的卫生工作者,尽管他们缺乏正式的培训,是向社区有糖尿病风险的人提供无障碍护理的重要合作伙伴。虽然糖尿病前期和糖尿病在社会经济地位低的人群中更为普遍,包括那些住在不足的房子里的人。然而,由于经济和社会上的不利因素,这些人口通常在获得正规护理服务方面存在问题。在高收入国家,发达的中国社会,这项务实的随机对照试验旨在调查6个月的外行卫生工作者干预在居住在香港细分公寓的人群中糖尿病管理中的效果.
在这次审判中,222名居住在房屋不足且有糖尿病风险的中国主要照顾者将通过非营利组织招募,这些非营利组织服务于平均家庭收入较低的地区和香港普遍存在的细分公寓。采用6个月的等待名单控制,参与者将随机接受为期6个月的5个组成部分的非专业卫生工作者干预,包括(1)非专业卫生工作者培训和支持;(2)卫生专业培训;(3)针对家庭的健康和营养需求制定有针对性的护理计划;(4)病例管理办法;(5)非专业卫生工作者的财政补贴,以维持这种做法。对照组将接受有关糖尿病风险管理的常规护理和健康信息。糖化血红蛋白(HbA1c)和空腹血糖将在本试验的进入和退出评估时作为主要结果。
我们的随机对照试验是第一个调查非专业卫生工作者干预对居住在住房不足的中国低收入人群糖尿病前期管理的影响的试验之一。这项研究可以提供见解,以考虑社区中糖尿病风险人群的替代服务提供模式,通过提供由社区卫生工作者支持的护理选择和加强护理提供者的社区参与。本研究试图使用混合方法研究设计来评估非专业卫生工作者干预的影响。尽管做出了贡献,这项研究可能会受到抽样偏倚的影响,因为所有参与者都将从为贫困人群服务的非营利组织招募.
ChiCTR2100052080在中国临床试验注册。URL:https://www.chictr.org.cn/edit。aspx?pid=134928&htm=4。
Lay health workers, despite their lack of formal trainings, are important partners in providing accessible care to people with risk to develop diabetes in the community. While pre-diabetes and diabetes are more prevalent among people with low socio-economic status, including those living in inadequate houses. However, this population often have accessibility problems to formal care services due to their financial and social disadvantages. In a high-income, developed Chinese society, this pragmatic randomized controlled trial seeks to investigate the effect of a 6-months lay health worker intervention in diabetes management among people living in sub-divided flats units in Hong Kong.
In this trial, 222 Chinese primary caregivers living in inadequate houses and with diabetes risk will be recruited via non-profit organizations serving in districts with low average household incomes and prevalent subdivided flats in Hong Kong. Adopting a 6 months wait-list control, participants will be randomized to receive a 6-months lay health worker intervention of 5 components, including (1) lay health worker training and support; (2) health professional training; (3) formulation of a targeted care plan for the health and nutritional needs of the families; (4) case management approach; and (5) financial subsidy for lay health workers to sustain the practice. The control group will receive usual care and health information on diabetes risk management. Glycated hemoglobin (HbA1c) and fasting blood glucose will be taken at the entry and exit assessment of this trial as primary outcomes.
Our randomized controlled trial is one of the first to investigate the effect of lay health worker intervention on pre-diabetes management in a low-income Chinese population residing in inadequate houses. This study could provide insights to consider alternative service provision models to people living with diabetes risk in the community, by providing a care option to be supported by community health workers and enhanced community participation of care providers. This study attempts to evaluate the impact of a lay health worker intervention using a mixed-method study design. Despite its contribution, this study might be subjected to sampling bias since all the participants will be recruited from non-profit organizations serving deprived populations.
ChiCTR2100052080 in Chinese Clinical Trial Registry. URL: https://www.chictr.org.cn/edit.aspx?pid=134928&htm=4.