Diabetes Care in American Samoa

美属萨摩亚的糖尿病护理

• 批准号: 7287349
• 负责人: Stephen T. McGarvey
• 金额: $ 57.02万
• 依托单位: BROWN UNIVERSITY
• 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 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7287349
• 关键词: Accounting; Adherence; Adult; American; American Samoa; Appendix; Behavior; Caring; Centers for Disease Control and Prevention (U.S.); Clinical; Clinical Trials; Collaborations; Communities; Community Health; Community Health Centers; Community Practice; Community Workers; Control Groups; Dental; Diabetes Mellitus; Diet; Disease; Documentation; Economics; Education and Outreach; Effectiveness; Environment; Family; Family health status; Glycosylated hemoglobin A; Goals; Government; Guidelines; Hawaii; Health; Health Services; Health Services Accessibility; Health education; Healthcare; Healthcare Systems; Healthy People 2010; Hemoglobin; Individual; Institute of Medicine (U.S.); Intervention; Intervention Studies; Language; Link; Literature; Medical; Medical Care Team; Methods; Modeling; NIH Program Announcements; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Ophthalmic examination and evaluation; Outcome; Patients; Physical activity; Prevalence; Primary Health Care; Process; Provider; Public Health; Published Comment; Purpose; Randomized; Recommendation; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Role; Samoan; Self Management; Social support; Socioeconomic Status; Standards of Weights and Measures; System; Testing; Translating; Translational Research; Translations; United States; Waiting Lists; base; cardiovascular disorder risk; cardiovascular risk factor; community based service; diet and exercise; ethnic minority population; experience; falls; follow-up; foot; health care delivery; health disparity; health literacy; improved; member; outreach; programs; racial and ethnic; response

DESCRIPTION (provided by applicant): As type 2 diabetes prevalence increases in the United States, the burden of diabetes falls more on groups with greater barriers to care, such as language and cultural differences, and lower economic resources. Healthy People 2010 targeted diabetes as one of six diseases for the elimination of racial and ethnic health disparities. These disparities extend to the US Territory of American Samoa, where the proportion of adults >18 years with diabetes was 19.6% in 2002, compared to 6.4% of US adults. There have been no reported diabetes interventions in Samoans in the US. The overall purpose of this application is to translate recent advances in diabetes care into clinical practice for the American Samoan community by improving methods of health care delivery and improve methods of diabetes self management. We will use the community health worker model to test an expanded diabetes care model. Community health workers (CHW) have frequently been used to serve as "bridges" between health care services and patients in poor ethnic minority communities. CHW workers provide culturally appropriate health education and instrumental social support and facilitation, and even organization, of access to care, while also providing patient information to medical providers. We propose a clinical trial to test the effectiveness of a CHW and primary-care coordinated intervention to provide outreach, education and support to 352 type 2 diabetes patients and their families in American Samoa. The outcomes at a one-year follow-up will include glycosolated hemoglobin (HbA1c), cardiovascular disease risk factors, diet and exercise behaviors, and adherence to diabetes care guidelines. The intervention builds upon best clinical practices for diabetes care by translating effective strategies to American Samoans. The translation of good diabetes care there may offer a model that is potentially replicable in other ethnic minority populations suffering the burden of diabetes.

描述（由申请人提供）：随着美国 2 型糖尿病患病率的增加，糖尿病的负担更多地落在那些护理障碍更大的群体身上，例如语言和文化差异以及经济资源较低。 《2010 年健康人民》将糖尿病列为消除种族和民族健康差异的六种疾病之一。这些差异也延伸至美国属地美属萨摩亚，2002 年该地区 18 岁以上成年人患有糖尿病的比例为 19.6%，而美国成年人的这一比例为 6.4%。目前还没有美国萨摩亚人糖尿病干预措施的报道。该应用程序的总体目的是通过改进医疗保健提供方法和改进糖尿病自我管理方法，将糖尿病护理的最新进展转化为美属萨摩亚社区的临床实践。我们将使用社区卫生工作者模型来测试扩展的糖尿病护理模型。社区卫生工作者 (CHW) 经常被用作贫困少数民族社区卫生保健服务和患者之间的“桥梁”。社区卫生工作者提供适合文化的健康教育以及工具性社会支持和便利，甚至组织获得护理的机会，同时还向医疗提供者提供患者信息。我们提议进行一项临床试验，以测试社区卫生工作者和初级保健协调干预措施的有效性，以便为美属萨摩亚 352 名 2 型糖尿病患者及其家人提供外展、教育和支持。一年随访的结果将包括糖化血红蛋白 (HbA1c)、心血管疾病危险因素、饮食和运动行为以及对糖尿病护理指南的遵守情况。该干预措施以糖尿病护理的最佳临床实践为基础，将有效的策略转化为美属萨摩亚人。良好的糖尿病护理的转化可能会提供一个模型，该模型可以在其他患有糖尿病的少数民族人群中复制。