PurposeThe purpose of the study was to explore a parent’s sense of meaning in relation to the parenting of a child with type 1diabetes.MethodsA qualitative collective case study design was used and 10 interviews conducted with parents of children with type 1 diabetes. Recruitment took place through the Winnipeg Diabetes Education and Resource for Children and Adolescents and Juvenile Diabetes Research Foundation. Categories were identified using qualitative content analysis.FindingsTwo major categories identified include being like everyone else and protecting the children.ImplicationsFindings indicate that there is a need for greater diabetes education in schools. Diabetes educators can play a more proactive role in leading school based discussions with children, parents, and school staff. … [Read more...]
Training Peers to Deliver a Church-Based Diabetes Prevention Program
Purpose:The purpose of this study was to examine the feasibility and acceptability of training peers to function as lifestyle coaches and to deliver a church-based lifestyle modification program.Methods:We recruited 6 African-American adults to participate in an 8-hour peer lifestyle coach (PLC) training program followed by a subsequent 2-hour booster session. The PLC training program addressed several key areas, including: (1) developing empowerment-based facilitation, active listening, and behavior change skills; (2) learning self-management strategies (eg, reading food labels, counting calories); (3) practicing session delivery; and (4) interpreting clinical lab results. Training evaluation was conducted retrospectively (immediately following the delivery of the diabetes prevention intervention rather than after … [Read more...]
Afrocentric Cultural Values and Beliefs: Movement Beyond the Race and Ethnicity Proxy to Understand Views of Diabetes
PurposeThe purpose of this study was to estimate the benefit of using a cultural characteristics scale to help diabetes educators understand how African Americans cope with diabetes. Illness representations are influenced by culture. Race and ethnicity as a proxy for culture provides an incomplete understanding of the mechanism by which cultural values influence representations of diabetes.MethodsA descriptive correlational design was employed by recruiting hospitalized adults with type 2 diabetes at 3 metropolitan northeast coast sites. The TRIOS Afrocentric cultural characteristics measure and the Illness Perception Questionnaire were administered by paper-and-pencil to a diverse sample. Black race and African American ethnicity was used as a proxy for culture and compared to levels of agreement on an Afrocentric cultural scale to determine the relative ability to explain variance in illness representations of diabetes.ConclusionThe TRIOS measure adapted to diabetes care explained … [Read more...]
Patient and Physician Factors Associated With Adherence to Diabetes Medications
Purpose The purpose of this study was to examine the influence of patient and physician psychosocial, sociodemographic, and disease-related factors on diabetes medication adherence. These factors were also examined as effect modifiers of the association between quality of the patient-physician relationship and medication adherence. Methods Data were collected from 41 Geisinger Clinic primary care physicians and 608 of their patients with type 2 diabetes. Adherence to oral hypoglycemic medications was calculated using a medication possession ratio based on physician orders in electronic health records (MPREHR). MPREHR was defined as the proportion of total time in the 2 years prior to study enrollment that the patient was in possession of oral hypoglycemic medications. Linear regression was used to examine the influence of patient- and physician-level factors on adherence. Effect modification of the patient-physician relationship-adherence association was evaluated by adding the main … [Read more...]
Association Between Spirituality and Depression in Adults With Type 2 Diabetes
Purpose The purpose of the study was to examine the association between spirituality and depression among patients with type 2 diabetes. Methods This study included 201 adult participants with diabetes from an indigent clinic of an academic medical center. Participants completed validated surveys on spirituality and depression. The Daily Spiritual Experience (DSE) Scale measured a person’s perception of the transcendent (God, the divine) in daily life. The Center for Epidemiologic Studies–Depression scale assessed depression. Linear regression analyses examined the association of spirituality as the predictor with depression as the outcome, adjusted for confounding variables. Results Greater spirituality was reported among females, non-Hispanic blacks, those with lower educational levels, and those with lower income. The unadjusted regression model showed greater spirituality was associated with less depression. This association was mildly diminished but still significant … [Read more...]
Effect of a Short-Duration, Culturally Tailored, Community-Based Diabetes Self-management Intervention for Korean Immigrants: A Pilot Study
Purpose The purpose of this pilot study was to assess the effectiveness, feasibility, and acceptability of a short-duration, culturally tailored, community-based diabetes self- management program (CTCDSP) for Korean immigrants with type 2 diabetes delivered at a non-clinic-affiliated community center. Methods Forty-one Korean adults with type 2 diabetes participated in a 2-session CTCDSP delivered by a bilingual nurse practitioner at a Korean community center. Outcome measures included biological, behavioral, and general health well-being; diabetes knowledge; and self-efficacy assessed at baseline, post-education, and 3-month follow-up. Repeated-measures analyses of variance were used to explore mean differences in outcomes across the 3 assessment points. Results From baseline to 3-month follow-up assessment, participants exhibited significant improvement on several physiological and behavioral measures. Mean levels of hemoglobin A1c and waist circumference decreased, whereas … [Read more...]
Building Capacity to Reduce Disparities in Diabetes: Training Community Health Workers Using an Integrated Distance Learning Model
Purpose The purpose of this study is to determine whether an innovative interactive distance training program is an effective modality to train community health workers (CHWs) to become members of the diabetes health care team. The University of New Mexico Health Sciences Center has developed a rigorous diabetes training program for CHWs involving both distance and hands-on learning as part of Project ECHO™ (Extension for Community Healthcare Outcomes). Methods Twenty-three diverse CHW participants from across New Mexico were enrolled in the first training session. Participants completed surveys at baseline and at the end of the program. They attended a 3-day hands-on training session, followed by weekly participation in tele/video conferences for 6 months. Wilcoxon signed-rank statistics were used to compare pre- and posttest results. Results Participants demonstrated significant improvements in diabetes knowledge (P = .002), diabetes attitudes (P = .04) and confidence in both … [Read more...]
A Motivational Peer Support Program for Type 2 Diabetes Prevention Delivered by People With Type 2 Diabetes: The UEA-IFG Feasibility Study
Purpose The purpose of this study was to develop a peer support program for individuals at high risk of type 2 diabetes as part of a novel Diabetes Prevention Programme (The UEA-IFG Study). Lay members of the public with existing type 2 diabetes volunteered as peer supporters (termed type 2 trainers) for participants at high risk of developing type 2 diabetes. The feasibility of type 2 trainer recruitment, training, and retention was tested. Methods Between January and September 2009, 1500 potential type 2 trainers with existing type 2 diabetes were contacted and 168 (11%) expressed an interest. From this group, 26 type 2 trainers were appointed to begin training. All completed 7 training seminars, covering diabetes prevention, nutrition, physical activity, listening skills, motivation, and goal planning. Motivational calls were made every 12 weeks to each study participant by each type 2 trainer in addition to health care professional–delivered education … [Read more...]
Association Between Glycosylated Hemoglobin and Intentional Weight Loss in Overweight and Obese Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study
Purpose The purpose of this study is to assess the relationship between magnitude of weight loss and improvement in percentage A1C (A1C%) among overweight and obese patients with type 2 diabetes mellitus (DM) undergoing weight reduction. Methods Case records of patients enrolled in 2 university-based weight management programs were reviewed. Patients were sampled if they had a diagnosis of DM and had at least 1 documented A1C% reduction from their baseline value. Weight loss treatment was individualized and consisted of a calorie-restricted diet, a behavior modification plan, and a plan for increasing physical activity. Patient weights were measured at bimonthly visits. A1C% was measured every 3 months. Results Seventy-two patients formed the study cohort. Mean baseline body mass index was 35.1 kg/m2, mean age was 52.6 years, and 59% were males. Mean starting A1C% was 8.6. Patients achieved significant mean weight loss (10.7 kg) at study exit. Weight loss of 6.5 kg (4.5% of baseline … [Read more...]
Pharmacists’ Impact on Improving Outcomes in Patients With Type 2 Diabetes Mellitus
Purpose The purpose of this study was to evaluate a diabetes education program that includes a pharmacist as a member of the diabetes management team by assessing the change in hemoglobin A1c (A1C), cholesterol, and blood pressure for patients with type 2 diabetes in outpatient clinics. Methods This was a retrospective study in outpatient clinics at Shands Jacksonville Medical Center. The patients were assigned into either the pharmacist group or the nonpharmacist group, according to the presence or the absence of a pharmacist in the clinic. The primary end point was the absolute change in A1C versus baseline. Secondary end points included change in cholesterol and blood pressure and the number of patients to attain American Diabetes Association goals. End points were recorded to correlate within 3 months of the initial visit and final visit with a provider. Results Compared to the nonpharmacist group, patients in the pharmacist group had more advanced and uncontrolled diabetes at … [Read more...]
