Diabetes Care in American Samoa

美属萨摩亚的糖尿病护理

• 批准号: 8072928
• 负责人: Stephen T. McGarvey
• 金额: $ 9.64万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-06-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8072928
• 关键词: Accounting; Adherence; Adult; American; American Samoa; Behavior; Caring; Centers for Disease Control and Prevention (U.S.); Clinical Trials; Collaborations; Communities; Community Health; Community Health Centers; 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; Randomized; Recommendation; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Role; Samoan; Self Management; Social support; System; Testing; Translating; Translational Research; Translations; United States; Waiting Lists; base; cardiovascular disorder risk; cardiovascular risk factor; clinical practice; community based service; diabetes control; diet and exercise; ethnic minority population; experience; falls; follow-up; foot; group intervention; health care delivery; health disparity; health literacy; improved; low socioeconomic status; member; outreach; programs; racial and ethnic; response; socioeconomics; treatment as usual

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具有更大护理障碍的群体上，例如语言和文化差异，以及较低的经济资源。 2010年健康人将糖尿病作为消除种族和种族健康差异的六种疾病之一。这些差异扩展到了美国萨摩亚的美国领土，在2002年，成年人> 18年的成年人比例为19.6％，而美国成年人中有6.4％。在美国，萨摩亚人尚无报告的糖尿病干预措施。该应用程序的总体目的是通过改善医疗保健提供方法并改善糖尿病自我管理方法，将糖尿病护理的最新进展转化为美国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的卫生保健服务与患者之间的“桥梁”。 CHW的工人提供了适当的文化健康教育以及工具性的社会支持和促进，甚至提供了获得护理的机会，同时还向医疗提供者提供了患者信息。我们提出了一项临床试验，以测试CHW和初级护理协调干预措施的有效性，以向美国萨摩亚的352例2型糖尿病患者及其家人提供外展，教育和支持。为期一年的随访结果包括糖化血红蛋白（HBA1C），心血管疾病危险因素，饮食和运动行为以及遵守糖尿病护理指南。干预措施是基于糖尿病护理的最佳临床实践，通过将有效的策略转化为美国萨摩亚人。良好的糖尿病护理的翻译可能会提供一种模型，该模型可能在其他少数族裔人群中具有糖尿病负担。

项目成果

Long-Term Impact of a Community Health Worker Intervention on Diabetes Control in American Samoa.

社区卫生工作者干预对美属萨摩亚糖尿病控制的长期影响。

• DOI: 10.5888/pcd12.150160
• 发表时间: 2015
• 期刊: Preventing chronic disease
• 影响因子: 5.5
• 作者: Rao,Mayuree;DePue,JudithD;Dunsiger,Shira;Elsayed,Mohammad;Nu'usolia,Ofeira;McGarvey,StephenT
• 通讯作者: McGarvey,StephenT

Patient and health care provider views of depressive symptoms and diabetes in American Samoa.

患者和医疗保健提供者对美属萨摩亚抑郁症状和糖尿病的看法。

• DOI: 10.1037/a0020089
• 发表时间: 2010
• 期刊: Cultural diversity & ethnic minority psychology
• 影响因子: 3.3
• 作者: Held,RachelForster;DePue,Judith;Rosen,Rochelle;Bereolos,Nicole;Nu'usolia,Ofeira;Tuitele,John;Goldstein,Michael;House,Meaghan;McGarvey,Stephen
• 通讯作者: McGarvey,Stephen

Living with Ma'i Suka: individual, familial, cultural, and environmental stress among patients with type 2 diabetes mellitus and their caregivers in American Samoa.

与 Mai Suka 一起生活：美属萨摩亚 2 型糖尿病患者及其护理人员的个人、家庭、文化和环境压力。

• 发表时间: 2008
• 期刊: Preventing chronic disease
• 影响因子: 5.5
• 作者: Elstad,Emily;Tusiofo,Corabelle;Rosen,RochelleK;McGarvey,StephenT
• 通讯作者: McGarvey,StephenT

Gestational weight gain among American Samoan women and its impact on delivery and infant outcomes.

• DOI: 10.1186/s12884-015-0451-1
• 发表时间: 2015-02-03
• 期刊: BMC pregnancy and childbirth
• 影响因子: 3.1
• 作者: Hawley NL;Johnson W;Hart CN;Triche EW;Ah Ching J;Muasau-Howard B;McGarvey ST
• 通讯作者: McGarvey ST