To examine the effects of a community-based behavioral intervention with multiple components on health outcomes among low-income and uninsured adults who were obese and had diabetes and treated in a “real-world” setting.
Design:
A longitudinal design with a retrospective comparison group was used to examine the ability of a health promotion program to improve body mass index (BMI) and hemoglobin A1c (HbA1c) among 87 treatment group and 62 comparison group participants.
Setting:
Urban/metropolitan city in the United States.
Intervention:
A community-based behavioral intervention with 3 components including health-coach visits, registered dietitian visits, and exercise consultations delivered over 12 months.
Measures:
Biometric measurements were collected at baseline, 3, 6, 9, 12, and 18 months, whereas self-reported measurements were collected at baseline, 6 months, and 12 months.
Analysis:
Linear mixed models with participant-level random intercepts were fitted for BMI and HbA1c.
Results:
The treatment group demonstrated reductions in BMI (percentage change = −2.1%, P < .001) and HbA1c (−0.6%, P < .001) as well as improvement in diabetes knowledge (+5.4%, P = .025), whereas the comparison group did not show any improvements in biometric measures. Dietitian visits were the most effective treatment component to reduce HbA1c (coefficient = −0.08, P = .025).
Conclusion:
Multiple component behavioral intervention in community settings, particularly when delivered by registered dietitians, shows promise to combat the dual epidemic of obesity and diabetes among low-income and uninsured patients.
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