Randomized Trial of a Literacy-Sensitive, Culturally Tailored Diabetes Self-Management Intervention for Low-Income Latinos
| Autor: | Angela Cadavid Restrepo, Amy Borg, Mary Jo White, Ira S. Ockene, Lucy M. Candib, Jeffrey Scavron, Milagros C. Rosal, Barbara C. Olendzki, Garry Welch, George H Reed |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Research design Gerontology Adolescent Endocrinology Diabetes and Metabolism Saturated fat Psychological intervention Blood sugar 030209 endocrinology & metabolism Type 2 diabetes law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Diabetes mellitus Internal Medicine medicine Humans 030212 general & internal medicine Poverty Original Research Aged Glycemic Glycated Hemoglobin Advanced and Specialized Nursing business.industry Blood Glucose Self-Monitoring Clinical Care/Education/Nutrition/Psychosocial Research Hispanic or Latino Middle Aged medicine.disease Health Literacy Self Care Diabetes Mellitus Type 2 Female business |
| Zdroj: | Diabetes Care |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc10-1981 |
| Popis: | OBJECTIVE To test whether a theory-based, literacy, and culturally tailored self-management intervention, Latinos en Control, improves glycemic control among low-income Latinos with type 2 diabetes. RESEARCH DESIGN AND METHODS A total of 252 patients recruited from community health centers were randomized to the Latinos en Control intervention or to usual care. The primarily group-based intervention consisted of 12 weekly and 8 monthly sessions and targeted knowledge, attitudes, and self-management behaviors. The primary outcome was HbA1c. Secondary outcomes included diet, physical activity, blood glucose self-monitoring, diabetes knowledge and self-efficacy, and other physiological factors (e.g., lipids, blood pressure, and weight). Measures were collected at baseline and at 4- and 12-month follow-up. Change in outcomes over time between the groups and the association between HbA1c and possible mediators were estimated using mixed-effects models and an intention-to-treat approach. RESULTS A significant difference in HbA1c change between the groups was observed at 4 months (intervention −0.88 [−1.15 to −0.60] versus control −0.35 [−0.62 to 0.07], P < 0.01), although this difference decreased and lost statistical significance at 12 months (intervention −0.46 [−0.77 to −0.13] versus control −0.20 [−0.53 to 0.13], P = 0.293). The intervention resulted in significant change differences in diabetes knowledge at 12 months (P = 0.001), self-efficacy (P = 0.001), blood glucose self-monitoring (P = 0.02), and diet, including dietary quality (P = 0.01), kilocalories consumed (P < 0.001), percentage of fat (P = 0.003), and percentage of saturated fat (P = 0.04). These changes were in turn significantly associated with HbA1c change at 12 months. CONCLUSIONS Literacy-sensitive, culturally tailored interventions can improve diabetes control among low-income Latinos; however, strategies to sustain improvements are needed. |
| Databáze: | OpenAIRE |
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