Self Care Interventions for Black Women with Type 2DM

2 型糖尿病黑人女性的自我护理干预措施

基本信息

批准号：
6395420
负责人：
GAIL D MELKUS
金额：
$ 36.15万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2001
资助国家：
美国
起止时间：
2001-07-01 至 2006-03-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Black women experience one of the highest rates of type 2 diabetes mellitus (DM) and suffer disproportionately from diabetes related complications. Diabetes is now the second leading cause of death among black women. This can be attributed to poor diabetes control often due to sub-standard diabetes care and lack of diabetes education and self-management skills. The purpose of this study in black American women with type 2 DM is to evaluate the effect of a tested, culturally sensitive intervention of diabetes education, coping skills training (CST), and diabetes care designed to improve glycemic control and to empower them with the knowledge and skills necessary to assume self-management. The study is designed to: (1) determine the effect of the experimental intervention on glycemic control, specifically Hemoglobin Alc, by comparing it to a control group of conventional care at baseline, 3, 6, 9, 12, 24 and 36 months; (2) to determine the relationship of weight (BMI), lipid levels, blood pressure and the primary outcome of glycemic control; and (3) to determine the effect of the experimental intervention on self-efficacy with diabetes self-management and quality of life. Black women (N=129) with type 2 DM will be randomized to one of two groups: (1) a 6 week culturally sensitive cognitive-behavioral diabetes education program, followed by 5 weeks of CST and diabetes care visits, or (2) conventional care of a 5 week standard diabetes education program, 5 weekly patient-generated discussion sessions and diabetes care visits. Care will be the same for both groups and will be based on a treatment algorithim consistent with ADA care guidelines. The culturally sensitive education program will be led by advanced practice nurses trained in use of the program. Nurse practitioner and physician teams from collaborating primary care centers will see all subjects for care visits. Data will be collected at baseline 3, 6, 9, 12, 24, and 36 months. We hypothesize that women who receive the experimental intervention will have significantly better glycemic control, and will have significantly greater self-efficacy with diabetes self-management and quality of life compared to women receiving conventional diabetes education and care. Data analysis specific to each study aim will be conducted using ANOVA and multiple regression. The findings from this study will benefit the health outcomes of black American women, who most often are cared for by primary care providers, in various health care settings throughout the trajectory of type 2 DM. Health care settings, particularly primary care centers, will benefit from a tested, model intervention of diabetes care that will improve diabetes outcomes and contribute to decreasing the personal and public health burden of the disease.

描述（由申请人提供）：黑人妇女体验最高的 2型糖尿病（DM）的发生率不成比例与糖尿病有关的并发症。糖尿病现在是黑人妇女死亡。这可以归因于糖尿病控制不良由于不合格的糖尿病护理以及缺乏糖尿病教育和自我管理技能。这项研究的目的是在美国黑人妇女中 2型DM是评估经过培养敏感的测试的效果糖尿病教育，应对技能培训（CST）和糖尿病的干预旨在改善血糖控制的护理，并通过实现自我管理所需的知识和技能。该研究的设计至：（1）确定实验干预对血糖的影响对照，特别是血红蛋白ALC，将其与对照组进行比较基线3、6、9、12、24和36个月的常规护理；（2）确定体重（BMI），脂质水平，血压和主要的关系血糖控制的结果；（3）确定对糖尿病自我管理的自我效能的实验干预和生活质量。 2型DM的黑人妇女（n = 129）将随机分为一个两组：（1）一个6周对文化敏感的认知行为糖尿病教育计划，然后进行5周的CST和糖尿病护理访问，或（2） 5周标准糖尿病教育计划的常规护理，第5周患者生成的讨论会议和糖尿病护理就诊。关心会两组相同，将基于治疗算法一致使用ADA护理指南。对文化敏感的教育计划将是由接受该计划的高级实践护士领导。护士合作的初级保健中心的从业者和医师团队将请参阅所有主题进行护理访问。数据将在基线3、6、9， 12、24和36个月。我们假设接受实验的女性干预将具有明显更好的血糖控制，并将具有糖尿病自我管理和质量的自我效能显着更大与接受常规糖尿病教育和护理的妇女相比。每个研究目的的数据分析将使用ANOVA和多重回归。这项研究的发现将使健康受益黑人妇女的结果，她们通常受到初级保健的照顾提供者，在2型轨迹的各种医疗保健环境中 DM。医疗保健环境，尤其是初级保健中心，将受益于经过测试的糖尿病护理模型干预，可以改善糖尿病成果并有助于减轻个人和公共卫生负担疾病。