「智慧生活家」方案之評值與修正－台灣糖尿病預防計畫之經驗

The diabetes was the fourth of leading causes of the death in Taiwan. The Diabetes Prevention Program promoting health lifestyle modification effectively prevented 58% occurrence of type 2 diabetes. Investigators used CIPP (context, input, process, and product) model to evaluate and revise this program to develop a culture sensitive program. The samples were 217 prediabetes clients and 19 public health nurses. The results were the following. Context: the case managers needed to empower and practice on consultations. Almost half of the case managers' physical activity and high fiber intake behaviors were on the contemplation stage. Most cases needed consultations that focused on more physical activity behaviors. Input: investigators and case managers revised the materials of the native Diabetes Prevention Program for people who have prediabetes which includes administrative guides, case manager handbooks, etc. Process: encouraging cases participation, recording and tracking were well done by case managers. Challenges were problem solving and increasing the case managers' sense of achievement. Product: after six months, cases had more moderate physical activity (250 minutes/week) and weight reduction (3.1%). Through continuative evaluation and revision by investigators, clients and cases managers, the culture-sensitive Diabetes Prevention Program will be suitable for decreasing the incidence of type 2 diabetes in Taiwan.