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Pyo E, Weber MB, Sivaram J, Staimez LR, Mohan V, Anjana RM, Haardörfer R, Ranjani H. Construct validity of the 12-item Short Form Health Survey (SF-12) version 2 and the impact of lifestyle modifications on the health-related quality of life among Indian adults with prediabetes: results from the D-CLIP trial. Qual Life Res 2024:10.1007/s11136-024-03648-6. [PMID: 38607494 DOI: 10.1007/s11136-024-03648-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE This study aimed to validate the factor structure of the 12-item Short-Form (SF-12) health-related quality of life (HRQOL) survey for Indian adults and assess the impact of lifestyle modification on the SF-12 of Indian adults with prediabetes. METHODS To validate the context-specific construct of the SF-12, two-factor confirmatory factor analysis (CFA) was performed using data from 1285 adults residing in Chennai, India, who screened for the Diabetes Community Lifestyle Improvement Program (D-CLIP). D-CLIP was a randomized controlled trial of 578 participants with prediabetes (283 treatment, 293 control), focusing on the effect of lifestyle modifications on the prevention of diabetes. Physical and mental component scores (PCS and MCS) were computed by using CFA standardized factor loadings. Multiple linear regression was subsequently conducted to estimate the effect of lifestyle modification on post-study changes of PCS and MCS among D-CLIP participants. RESULTS Cronbach's alpha and CFA fit indices demonstrated acceptable reliability and model fit of the SF-12 for Indian adults. The intervention group showed greater mean change in PCS after study participation compared to the controls (1.63 ± 0.82, p = 0.046); no significant difference was observed for MCS between two groups (1.00 ± 0.85, p = 0.242). CONCLUSION The study confirmed that the SF-12 is suitable for assessing the physical and mental health dimensions of HRQOL for Indian adults. Our findings suggest that the benefits of diabetes prevention lifestyle modification strategies may primarily enhance the physical well-being of adults with prediabetes. Further studies validating the SF-12 in a broader Asian Indian population are needed. TRIAL REGISTRATION Clinicaltrials.gov, NCT01283308.
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Affiliation(s)
- Euisun Pyo
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA.
| | - Mary Beth Weber
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, 30322, USA
| | | | - Lisa R Staimez
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center, Emory University, Atlanta, GA, 30322, USA
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Regine Haardörfer
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Harish Ranjani
- Department of Preventive and Digital Health Research, Madras Diabetes Research Foundation, Chennai, India
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Rhodes E, Hennink M, Jose P, Sivaram J, Ranjani H, Jeemon P, Weber MB. Using Peer Educators to Deliver a Worksite-Based Lifestyle Program to Reduce Cardiometabolic Risk in India. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa059_060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
We sought to understand the feasibility, acceptability, and sustainability of using peer educators to deliver a worksite-based lifestyle intervention program to reduce cardiometabolic risk in India.
Methods
INtegrating DIAbetes prevention in WORKplaceS (INDIA-WORKS, Clinicaltrial.gov #NCT02813668) is an implementation study to evaluate a lifestyle intervention program targeting employees with prediabetes or newly diagnosed diabetes in ten worksites in India. Peer educators were recruited at each worksite and trained to teach lifestyle classes. We conducted in-depth interviews with managers (n = 16), peer educators (n = 29), and implementation team members (n = 8) and focus group discussions with employees participating in the program (n = 13) to evaluate program delivery, including use of peer educators in this setting. Interviews and focus groups were conducted in-person, audio-recorded, and transcribed verbatim. Data were analyzed using thematic analysis.
Results
Peer educators’ involvement in teaching classes varied across worksites. This variation was related to differences in the training peer educators received, degree of management support provided, and peer educators’ levels of confidence to teach classes (e.g., discuss nutrition topics). Most peer educators liked their role, as it allowed them to learn about lifestyle change and benefit other employees (e.g., by encouraging them to be physically active), themselves (e.g., by losing weight), and their families (e.g., by preparing and serving healthier meals at home). Many employees participating in the program were satisfied with the peer educators, though some preferred “experts” such as implementation team members to lead classes. For program sustainability, there remains a need to increase peer educators’ capacity to teach classes and maintain their motivation.
Conclusions
Findings indicate that while it may be feasible for peer educators to deliver worksite-based lifestyle programs in India, it is critical to ensure that they have confidence and training, management support, and motivation to carry out their role. Research is needed to understand the type of training and support necessary to develop a cadre of effective peer educators and strategies for sustaining their engagement in the program.
Funding Sources
NIH R01HL125442 NIH D43TW009337.
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