{"doi":"10.1093/ije/dyab072","title":"<i>Meta Salud Diabetes</i> for cardiovascular disease prevention in Mexico: a cluster-randomized behavioural clinical trial","abstract":"BACKGROUND: Healthy lifestyle interventions offered at points of care, including support groups, may improve chronic disease management, especially in low-resource populations. We assessed the effectiveness of an educational intervention in type 2 diabetes (T2D) support groups to reduce cardiovascular disease (CVD) risk. METHODS: We recruited 518 participants to a parallel, two-arm, cluster-randomized, behavioural clinical trial across 22 clinics in Sonora, Mexico, between August 2016 and October 2018. We delivered a 13-week secondary prevention intervention, Meta Salud Diabetes (MSD), within the structure of a support group (GAM: Grupo de Ayuda Mutua) in government-run (community) Health Centres (Centros de Salud). The primary study outcomes were difference in Framingham CVD risk scores and hypertension between intervention (GAM+MSD) and control (GAM usual care) arms at 3 and 12 months. RESULTS: CVD risk was 3.17% age-points lower in the MSD arm versus control at 3 months [95% confidence interval (CI): -5.60, -0.75, P = 0.013); at 12 months the difference was 2.13% age-points (95% CI: -4.60, 0.34, P = 0.088). There was no evidence of a difference in hypertension rates between arms. Diabetes distress was also lower at 3 and 12 months in the MSD arm. Post-hoc analyses showed greater CVD risk reduction among men than women and among participants with HbA1c < 8. CONCLUSIONS: MSD contributed to a positive trend in reducing CVD risk in a low-resource setting. This study introduced an evidence-based curriculum that provides T2D self-management strategies for those with controlled T2D (i.e. HbA1c < 8.0) and may improve quality of life.","journal":"International Journal of Epidemiology","year":2021,"id":197344,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9632,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":771292,"name":"Catalina A. Denman","orcid":"0000-0001-8137-4562","position":1,"is_corresponding":false},{"id":298654,"name":"Melanie L. Bell","orcid":"0000-0003-4821-4094","position":2,"is_corresponding":false},{"id":771934,"name":"E Cornejo","orcid":null,"position":3,"is_corresponding":false},{"id":690928,"name":"Maia Ingram","orcid":"0000-0002-6517-7697","position":4,"is_corresponding":false},{"id":771293,"name":"María del Carmen Castro Vásquez","orcid":"0000-0001-6406-6728","position":5,"is_corresponding":false},{"id":770595,"name":"Jesús Eduardo González-Fagoaga","orcid":"0000-0003-1855-0564","position":6,"is_corresponding":false},{"id":771294,"name":"Benjamín Aceves","orcid":"0000-0003-1683-5195","position":7,"is_corresponding":false},{"id":771295,"name":"Tomas Nuño","orcid":"0000-0003-1729-0705","position":8,"is_corresponding":false},{"id":311644,"name":"Elizabeth J. Anderson","orcid":"0000-0002-9137-6518","position":9,"is_corresponding":false},{"id":771935,"name":"Jill Guernsey de Zapien","orcid":null,"position":10,"is_corresponding":false},{"id":311646,"name":"Cecilia Rosales","orcid":"0000-0002-1576-9272","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-18T23:50:23.532351Z","pmid":"33842978","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}