Evidence mapPaperPMID 32487594Full record

Trial reportBMJ open diabetes research & care2020

Health literacy and exercise interventions on clinical outcomes in Chinese patients with diabetes: a propensity score-matched comparison.

Yan Wei, Yingyao Chen, Yingnan Zhao, Russell Rothman, Jian Ming, Lei Wang, Xiaona Liu, Lizheng Shi, Wanghong Xu

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. The Effect of Health Literacy Intervention on Patients with Diabetes: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Yan WeiKey Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China.
Yingyao ChenKey Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China.
Yingnan ZhaoDivision of Clinical and Administrative Science, College of Pharmacy, Xavier University of Louisiana, Louisiana, New Orleans, USA.
Russell RothmanDepartment of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jian MingKey Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China.
Lei WangDepartment of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (National Ministry of Education), Fudan University, Shanghai, China.
Xiaona LiuDepartment of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (National Ministry of Education), Fudan University, Shanghai, China.
Lizheng ShiDepartment of Global Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.
Wanghong XuDepartment of Epidemiology, School of Public Health and Key Laboratory of Public Health Safety (National Ministry of Education), Fudan University, Shanghai, China wanghong.xu@fudan.edu.cn.ORCID 0000-0003-2045-2218
Fudan University · CNTulane University · USVanderbilt University Medical Center · USXavier University of Louisiana · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPatients with diabetes in China have low health literacy, which likely leads to poor clinical outcomes. This study aimed to assess the effectiveness of health literacy and exercise interventions on clinical measurements in Chinese adults with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND

methodsA cluster randomized controlled trial was conducted from February 2015 through April 2017 in Shanghai, China. 799 patients with T2DM aged 18 years or older recruited from eight Community Healthcare Centers were randomized into one control arm and three intervention arms receiving 1-year health literacy intervention, exercise intervention or both as the comprehensive intervention. Propensity score matching was employed to minimize potential imbalance in randomization. The intervention-attributable effects on main clinical outcomes were estimated using a difference-in-difference regression approach.

resultsAfter propensity score matching, 634 patients were included in the analysis. The three intervention groups had decreased hemoglobin A1c (A1c) level after 12 months of intervention. The largest adjusted decrease was observed in the health literacy group (-0.95%, 95% CI: -1.30 to -0.59), followed by the exercise group (-0.81%, 95% CI: -1.17 to -0.45). However, A1c was observed to increase in the health literacy and the comprehensive groups from 12 to 24 months. No obvious changes were observed for other measurements including high-density and low-density lipoprotein cholesterols, and systolic and diastolic blood pressures.

conclusionsHealth literacy and exercise-focused interventions improve glycemic control in Chinese patients with diabetes after 12 months of intervention, and the health literacy intervention shows the greatest effect. Our results suggest that the interventions may have the potential to improve diabetes self-management and reduce diabetes burden in China. TRIAL REGISTRATION NUMBER: ISRCTN76130594.

Indexed as

Diabetes Mellitus, Type 2Health LiteracyAdultChinaExercise TherapyHumansPropensity Scoreadult diabetesexercisehealth literacyintervention trials

Identifiers

PMID32487594
PMCPMC7264995
OpenAlexW3032789906

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.