Evaluation of the effectiveness of Ajjmuurur Baamḷe DSMES in the RMI
Ajjmuurur Baamá¸e DSMES 在 RMI 中的有效性评估
基本信息
- 批准号:10364952
- 负责人:
- 金额:$ 64.49万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-02-01 至 2027-01-31
- 项目状态:未结题
- 来源:
- 关键词:Acquired BlindnessAddressAdherenceAffectAftercareArkansasBehaviorBehavioralBlood PressureBody mass indexCardiometabolic DiseaseCommunitiesCommunity Health AidesComplications of Diabetes MellitusDataDiabetes MellitusDistressEducationEducational CurriculumEvaluationFamilyFamily memberFastingFree AssociationFundingGlycosylated hemoglobin AGoalsHealthHealth ExpendituresHealthcareIndigenousInterventionKidney FailureKnowledgeLife ExpectancyLipidsLower ExtremityMarshall IslandsMeasuresModelingNon-Insulin-Dependent Diabetes MellitusOutcomePacific IslanderPacific IslandsParticipantPatient-Focused OutcomesPatientsPeriodicityPersonsPhysiciansPopulationPrevalenceProcessQuality of lifeRandomizedResearchResourcesRisk FactorsSelf EfficacySelf ManagementServicesUnited StatesUnited States National Institutes of HealthWaiting ListsWorkarmbasebehavior changebehavioral adherencecardiometabolic riskcommunity based participatory researchcommunity organizationscomparison groupcultural valuesdiabetes educatordiabetes self-managementeffectiveness evaluationeffectiveness testingempowermentexperiencefamily influencefamily supportfasting glucoseglycemic controlhealth care servicehealth disparityheart disease riskimprovedinnovationlimb amputationmedication complianceminority communitiesmotivational enhancement therapypost interventionprimary outcomepublic health relevancetreatment groupwaist circumference
项目摘要
ABSTRACT
Health disparities in the Republic of the Marshall Islands (RMI) are striking with extremely high rates of
diabetes and other cardiometabolic diseases. Documented rates of type 2 diabetes mellitus (T2DM) in the RMI
range from 20%-50%. This is significantly higher than global (8.5%) and US (11%) rates. The extreme
disparities in the RMI are exacerbated by a lack of research, lack of funding, a lack of services, and a lack of
culturally-appropriate interventions. Residents of the RMI experience unique barriers to self-management of
T2DM, as well as possess unique cultural assets that can be leveraged to help mitigate these barriers. The
research team worked with the Marshallese community in Arkansas to develop and evaluate a culturally-
adapted family model of DSMES (Ājjmuurur Baamḷe DSMES). Ājjmuurur Baamḷe DSMES is based on a
collectivist approach, incorporates Marshallese cultural practices, and uses “talk story” as a conversational,
rhythmic, and culturally preferred way of sharing knowledge. Ājjmuurur Baamḷe DSMES includes family
members as participants and focuses on family motivational interviewing, family goal setting, and family
behavioral change with specific focus on education about supportive and nonsupportive family behaviors. The
curriculum is assets based and it works to overcome barriers facing Marshallese patients by leveraging
culturally specific facilitators of healthy behavior change. Our central hypothesis is that persons who receive
the Family Model DSMES "Ājjmuurur Baamḷe" will have improved HbA1c (primary outcome), blood pressure,
lipids, BMI, increased knowledge, self-efficacy, empowerment, and quality of life, along with decreased
diabetes-related complications and diabetes-related distress. This study's objective is to conduct a cluster RCT
using a wait-list control to evaluate the effectiveness of Ājjmuurur Baamḷe DSMES when delivered in faith-
based organizations (FBOs) by Community Health Workers (CHWs). Our specific aims are: 1. Test the
effectiveness of Ājjmuurur Baamḷe DSMES to improve diabetes-related outcomes among Marshallese patients;
2. Evaluate the effect of Ājjmuurur Baamḷe DSMES on family members; and 3. Conduct an indigenous
evaluation to understand the extent to which the intervention adheres to Pacific Islander cultural values and
evaluate the cultural appropriateness of the research. Data will be collected from patients (Aim 1) and their
family members (Aim 2) at baseline, immediately post-intervention (12 weeks), at four months and twelve
months post-intervention. An indigenous evaluation (Aim 3) will be conducted at six months and each year
thereafter to document and inform process improvement efforts in study implementation. While the
Marshallese are a small population, this population is underrepresented in research, and they are experiencing
a health crisis that must be addressed. The proposed study offers a promising intervention that has the
potential to affect substantially health disparities experienced by Marshallese and other Pacific Islanders in the
USAPI.
抽象的
马绍尔群岛共和国 (RMI) 的健康差距十分惊人,患病率极高
RMI 中记录的糖尿病和其他心脏代谢疾病的发病率。
范围为 20%-50%,明显高于全球(8.5%)和美国(11%)的极端比率。
马绍尔群岛的差距因缺乏研究、缺乏资金、缺乏服务和缺乏
马绍尔群岛居民在自我管理方面遇到独特的障碍。
T2DM 以及拥有独特的文化资产,可以利用这些资产来帮助减轻这些障碍。
研究小组与阿肯色州的马绍尔社区合作,开发和评估文化-
DSMES 的适应家庭模型(Ājjmuurur Baamḷe DSMES)基于
集体主义方法,结合了马绍尔文化习俗,并使用“谈话故事”作为对话,
有节奏的、文化上偏好的知识共享方式。
成员作为参与者,重点关注家庭动机访谈、家庭目标设定和家庭
行为改变,特别关注支持性和非支持性家庭行为的教育。
课程以资产为基础,致力于通过利用资产来克服马绍尔患者面临的障碍
我们的中心假设是,接受健康行为的人会发生文化上特定的促进因素。
家庭模型 DSMES“Ājjmuurur Baamḷe”将改善 HbA1c(主要结果)、血压、
血脂、体重指数、知识增加、自我效能感、赋权和生活质量,以及生活质量的下降
糖尿病相关并发症和糖尿病相关困扰本研究的目的是进行整群随机对照试验。
使用等候名单控制来评估 Ājjmuurur Baamḷe DSMES 在信仰交付时的有效性 -
我们的具体目标是: 1. 测试
Ājjmuurur Baamḷe DSMES 对改善马绍尔患者糖尿病相关结果的有效性;
2. 评估 Ājjmuurur Baamḷe DSMES 对家庭成员的影响;以及 3. 开展本土化活动;
评估以了解干预措施符合太平洋岛民文化价值观的程度,以及
评估研究的文化适宜性将从患者(目标 1)及其患者那里收集数据。
基线时、干预后(12 周)、四个月和十二个月时的家庭成员(目标 2)
干预后几个月将进行一次本土评估(目标 3),并且每年将进行一次。
此后记录并告知研究实施中的流程改进工作。
马绍尔人人口较少,这一群体在研究中代表性不足,而且他们正在经历
一项必须解决的健康危机提出的研究提供了一种有希望的干预措施。
可能会对马绍尔人和其他太平洋岛民所经历的健康差异产生重大影响
美国API。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Pearl Mcelfish其他文献
Pearl Mcelfish的其他文献
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{{ truncateString('Pearl Mcelfish', 18)}}的其他基金
Home Food Delivery for Diabetes Management in Patients of Rural Clinics
农村诊所患者糖尿病管理的家庭送餐服务
- 批准号:
10438910 - 财政年份:2020
- 资助金额:
$ 64.49万 - 项目类别:
Home Food Delivery for Diabetes Management in Patients of Rural Clinics
农村诊所患者糖尿病管理的家庭送餐服务
- 批准号:
10636807 - 财政年份:2020
- 资助金额:
$ 64.49万 - 项目类别:
Connecting our Neighborhoods Need for Enhanced and Coordinated Testing to Achieve Equity: CoNNECT to Achieve Equality
连接我们的社区需要加强和协调测试以实现公平:连接以实现平等
- 批准号:
10254864 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES
通过家庭 DSMES 解决马绍尔移民糖尿病自我管理的障碍
- 批准号:
10469701 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Community-engaged partnership to reduce COVID-19 through self-testing in Hispanic and NHPI communities
社区参与伙伴关系,通过在西班牙裔和 NHPI 社区进行自我测试来减少 COVID-19
- 批准号:
10409310 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES
通过家庭 DSMES 解决马绍尔移民糖尿病自我管理的障碍
- 批准号:
10303001 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES
通过家庭 DSMES 解决马绍尔移民糖尿病自我管理的障碍
- 批准号:
10339360 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES
通过家庭 DSMES 解决马绍尔移民糖尿病自我管理的障碍
- 批准号:
10357616 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES
通过家庭 DSMES 解决马绍尔移民糖尿病自我管理的障碍
- 批准号:
10573211 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
Addressing Marshallese Immigrant Barriers to Diabetes Self-Management through Family DSMES
通过家庭 DSMES 解决马绍尔移民糖尿病自我管理的障碍
- 批准号:
10469701 - 财政年份:2019
- 资助金额:
$ 64.49万 - 项目类别:
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