Integrating Education Group Support and Case Management for Diabetic Hispanics

将教育团体支持与西班牙裔糖尿病患者案例管理相结合

• 批准号: 7212498
• 负责人: SHARON A BROWN
• 金额: $ 23.08万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-15 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7212498
• 关键词: Mexican Americans; behavioral /social science research tag; blood glucose; clinical research; clinical trials; cost effectiveness; counseling; culture; diabetes mellitus therapy; focus groups; health care service utilization; health disparity; health services research tag; human subject; human therapy evaluation; noninsulin dependent diabetes mellitus; nurse patient relations; outcomes research; patient care management; patient monitoring device; rural health; self care; telemedicine; therapy compliance

DESCRIPTION (provided by applicant): Starr County is a rural Texas-Mexico border community that is 98% Mexican American and has the highest diabetes-related death rate in Texas. Since 1988 we have demonstrated reductions in HbA1c through culturally competent diabetes self-management education, but effects diminished overtime. Results indicated that socio-cultural and personal barriers remained, preventing individuals from achieving optimal health outcomes. The proposed planning study will explore a strategy relatively untested in rural communities that will provide coordination of all aspects of an individual's diabetes care, including participation in our self-management intervention. We propose to conduct a pilot test of our previously tested 'compressed" self-management intervention enhanced by a nurse case manager in order to: 1) Define and refine the role of the nurse case manager (NCM) for a rural border community by conducting focus groups with a variety of groups in Starr County: a) participants in our previous intervention studies; b) physicians practicing on either side of the border who provide diabetes care for Texas border residents; c) local community health officials; d) other health care providers who provide diabetes care (nurses, dietitians, community health workers employed by local hospitals and clinics); e) key authority figures in the community (such as local Catholic priests, County officials); and f) experienced NCMs. 2) Determine the feasibility of employing a diabetes NCM in order to enhance the positive effects of our self- management interventions by comparing 2 groups: a) a combined strategy involving the nurse CM PLUS the "compressed" version of our diabetes self-management intervention previously tested; and b) "compressed" diabetes self-management intervention ALONE. We will conduct a pilot study in Starr County using a pretest/posttest control group design. 96 participants of current genetic studies will be recruited and assigned to 1 of the interventions. We will collect data at baseline and at 3 and 6 months on outcomes we have measured previously-HbA1c, FBG, lipids, blood pressure, knowledge, health behaviors (physical activity, dietary intake, glucose monitoring, and medication usage), and BMI. We plan to add 2 new variables: 1) health care utilization and 2) cost. Minimal data analysis will be performed during the proposed pilot project, since the intent is to determine intervention feasibility. Basic descriptive analyses (means, frequencies) and non-parametric comparisons will be performed; HLM will be used for exploratory purposes. The proposed study is a critical step in determining effective ways of sustaining the effects of diabetes self-management in Mexican American populations.

描述（由申请人提供）：斯塔尔县是德克萨斯州乡村 - 墨西哥边境社区，墨西哥裔美国人为98％，在德克萨斯州的糖尿病相关死亡率最高。自1988年以来，我们已经通过具有文化胜任的糖尿病自我管理教育来证明HBA1C减少了，但效果减少了加班。结果表明，社会文化和个人障碍仍然存在，以阻止个人实现最佳的健康成果。拟议的规划研究将探索一项在农村社区中相对未经测试的战略，将提供个人糖尿病护理各个方面的协调，包括参与我们的自我管理干预措施。我们建议对我们先前测试的“压缩”进行试验测试，由护士案件经理增强，以：1）通过与Starr县的各种群体进行各种群体来定义和完善护士案例经理（NCM）对农村边境社区的作用：卫生官员； d）其他医疗保健提供者（护士，营养师，当地医院雇用的社区卫生工作者和诊所的关键权威人物）；涉及护士CM的合并策略以及先前已测试的糖尿病自我管理干预的“压缩”版本； b）仅“压缩”糖尿病自我管理干预措施。我们将使用预测试/后测对照组设计在Starr县进行一项试点研究。 96名当前遗传研究的参与者将被招募并分配给其中1个干预措施。我们将在基线和3个月的结果时收集数据，以衡量以前的HBA1C，FBG，脂质，血压，知识，健康行为（体育活动，饮食摄入，葡萄糖监测和用药）和BMI。我们计划添加2个新变量：1）医疗保健利用和2）成本。在拟议的试点项目期间将进行最小的数据分析，因为目的是确定干预性。将进行基本的描述性分析（均值，频率）和非参数比较； HLM将用于探索目的。拟议的研究是确定维持糖尿病自我管理对墨西哥裔美国人人口影响的有效方法的关键步骤。