Abstract
OBJECTIVE Marshallese adults experience high rates of type 2 diabetes. Previous diabetes self-management education (DSME) interventions among Marshallese were unsuccessful. This study compared the extent to which two DSME interventions improved glycemic control, measured on the basis of change in glycated hemoglobin (HbA 1c ). RESEARCH DESIGN AND METHODS A two-arm randomized controlled trial compared a standard-model DSME (standard DSME) with a culturally adapted family-model DSME (adapted DSME). Marshallese adults with type 2 diabetes (n = 221) received either standard DSME in a community setting (n = 111) or adapted DSME in a home setting (n = 110). Outcome measures were assessed at baseline, immediately after the intervention, and at 6 and 12 months after the intervention and were examined with adjusted linear mixed-effects regression models. RESULTS Participants in the adapted DSME arm showed significantly greater declines in mean HbA 1c immediately (20.61% [95% CI 21.19, 20.03]; P = 0.038) and 12 months (20.77% [95% CI 21.38, 20.17]; P = 0.013) after the intervention than those in the standard DSME arm. Within the adapted DSME arm, participants had significant reductions in mean HbA 1c from baseline to immediately after the intervention (21.18% [95% CI 21.55, 20.81]), to 6 months (20.67% [95% CI 21.06, 20.28]), and to 12 months (20.87% [95% CI 21.28, 20.46]) (P < 0.001 for all). Participants in the standard DSME arm had significant reductions in mean HbA 1c from baseline to immediately after the intervention (20.55% [95% CI 20.93, 20.17]; P = 0.005). CONCLUSIONS Participants receiving the adapted DSME showed significantly greater reductions in mean HbA 1c immediately after and 12 months after the intervention than the reductions among those receiving standard DSME. This study adds to the body of research that shows the potential effectiveness of culturally adapted DSME that includes participants’ family members.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 849-858 |
| Number of pages | 10 |
| Journal | Diabetes care |
| Volume | 42 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2019 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Advanced and Specialized Nursing
Cite this
Comparative effectiveness and maintenance of diabetes self-management education interventions for Marshallese patients with type 2 diabetes : A randomized controlled trial. / McElfish, Pearl A.; Long, Christopher R.; Kohler, Peter; Yeary, Karen H.K.; Bursac, Zoran; Narcisse, Marie Rachelle; Felix, Holly C.; Rowland, Brett; Hudson, Jonell S.; Goulden, Peter A.
In: Diabetes care, Vol. 42, No. 5, 01.05.2019, p. 849-858.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Comparative effectiveness and maintenance of diabetes self-management education interventions for Marshallese patients with type 2 diabetes
T2 - A randomized controlled trial
AU - McElfish, Pearl A.
AU - Long, Christopher R.
AU - Kohler, Peter
AU - Yeary, Karen H.K.
AU - Bursac, Zoran
AU - Narcisse, Marie Rachelle
AU - Felix, Holly C.
AU - Rowland, Brett
AU - Hudson, Jonell S.
AU - Goulden, Peter A.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - OBJECTIVE Marshallese adults experience high rates of type 2 diabetes. Previous diabetes self-management education (DSME) interventions among Marshallese were unsuccessful. This study compared the extent to which two DSME interventions improved glycemic control, measured on the basis of change in glycated hemoglobin (HbA 1c ). RESEARCH DESIGN AND METHODS A two-arm randomized controlled trial compared a standard-model DSME (standard DSME) with a culturally adapted family-model DSME (adapted DSME). Marshallese adults with type 2 diabetes (n = 221) received either standard DSME in a community setting (n = 111) or adapted DSME in a home setting (n = 110). Outcome measures were assessed at baseline, immediately after the intervention, and at 6 and 12 months after the intervention and were examined with adjusted linear mixed-effects regression models. RESULTS Participants in the adapted DSME arm showed significantly greater declines in mean HbA 1c immediately (20.61% [95% CI 21.19, 20.03]; P = 0.038) and 12 months (20.77% [95% CI 21.38, 20.17]; P = 0.013) after the intervention than those in the standard DSME arm. Within the adapted DSME arm, participants had significant reductions in mean HbA 1c from baseline to immediately after the intervention (21.18% [95% CI 21.55, 20.81]), to 6 months (20.67% [95% CI 21.06, 20.28]), and to 12 months (20.87% [95% CI 21.28, 20.46]) (P < 0.001 for all). Participants in the standard DSME arm had significant reductions in mean HbA 1c from baseline to immediately after the intervention (20.55% [95% CI 20.93, 20.17]; P = 0.005). CONCLUSIONS Participants receiving the adapted DSME showed significantly greater reductions in mean HbA 1c immediately after and 12 months after the intervention than the reductions among those receiving standard DSME. This study adds to the body of research that shows the potential effectiveness of culturally adapted DSME that includes participants’ family members.
AB - OBJECTIVE Marshallese adults experience high rates of type 2 diabetes. Previous diabetes self-management education (DSME) interventions among Marshallese were unsuccessful. This study compared the extent to which two DSME interventions improved glycemic control, measured on the basis of change in glycated hemoglobin (HbA 1c ). RESEARCH DESIGN AND METHODS A two-arm randomized controlled trial compared a standard-model DSME (standard DSME) with a culturally adapted family-model DSME (adapted DSME). Marshallese adults with type 2 diabetes (n = 221) received either standard DSME in a community setting (n = 111) or adapted DSME in a home setting (n = 110). Outcome measures were assessed at baseline, immediately after the intervention, and at 6 and 12 months after the intervention and were examined with adjusted linear mixed-effects regression models. RESULTS Participants in the adapted DSME arm showed significantly greater declines in mean HbA 1c immediately (20.61% [95% CI 21.19, 20.03]; P = 0.038) and 12 months (20.77% [95% CI 21.38, 20.17]; P = 0.013) after the intervention than those in the standard DSME arm. Within the adapted DSME arm, participants had significant reductions in mean HbA 1c from baseline to immediately after the intervention (21.18% [95% CI 21.55, 20.81]), to 6 months (20.67% [95% CI 21.06, 20.28]), and to 12 months (20.87% [95% CI 21.28, 20.46]) (P < 0.001 for all). Participants in the standard DSME arm had significant reductions in mean HbA 1c from baseline to immediately after the intervention (20.55% [95% CI 20.93, 20.17]; P = 0.005). CONCLUSIONS Participants receiving the adapted DSME showed significantly greater reductions in mean HbA 1c immediately after and 12 months after the intervention than the reductions among those receiving standard DSME. This study adds to the body of research that shows the potential effectiveness of culturally adapted DSME that includes participants’ family members.
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U2 - 10.2337/dc18-1985
DO - 10.2337/dc18-1985
M3 - Article
VL - 42
SP - 849
EP - 858
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 5
ER -