title: Strong in body and spirit: lifestyle intervention for Native American adults with diabetes in 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.
  
  
  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 approximately 6 weeks apart over approximately 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 HbA(1c) level was assessed at 1 year.
  
  
  RESULTS
  Adjusted mean change in HbA(1c) value varied significantly across the three arms at 1 year (P = 0.05). The UC arm showed a statistically significant increase in adjusted mean HbA(1c) 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.
authors.affiliation: Department of Preventive Medicine, University of Southern California, Los Angeles 90033-9010, USA. sgillila@usc.edu
authors.forename: Susan S
authors.initials: SS
authors.lastname: Gilliland
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Georgia E
authors.initials: GE
authors.lastname: Perez
authors.forename: Janette S
authors.initials: JS
authors.lastname: Carter
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007198:Indians, North American; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009516:New Mexico; D010353:Patient Education as Topic / Q000379:methods; D012944:Social Support; D014280:Triglycerides / Q000097:blood
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides