Community-Based Diabetes Care for Korean American Immigrants

为韩裔美国移民提供社区糖尿病护理

• 批准号: 8103859
• 负责人: Miyong T Kim
• 金额: $ 60.89万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-20 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8103859
• 关键词: Address; Adult; Am 80; American; Asian Americans; Asians; Attitude; Behavior; Behavior Therapy; Behavioral; Caring; Case Management; Chronic Disease; Clinical Trials; Communication; Communities; Community Health; Control Groups; Counseling; Data; Diabetes Mellitus; Diet; Education; Educational Materials; Effectiveness; Experimental Designs; Family; Fostering; Generations; Glucose; Glycosylated hemoglobin A; Goals; Grant; Health; Health Insurance; Health Personnel; Health Resources; Health Services Accessibility; Healthcare; Hemoglobin; Home environment; Immigrant; Immigration; Intervention; Intervention Studies; Knowledge; Korean American; Koreans; Language; Lead; Medical; Mental Depression; Methodology; Minority; Minority Groups; Monitor; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Online Systems; Outcome; Participant; Patients; Phase; Pilot Projects; Population; Prevalence Study; Problem Solving; Process; Protocols documentation; Psychosocial Factor; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Risk; Sampling; Self Care; Self Efficacy; Social isolation; Source; Structure; System; Technology; Telephone; Terminology; Testing; Translating; Translational Research; Visual; Vulnerable Populations; Weight Gain; Work; base; blood glucose regulation; blood pressure regulation; checkup examination; clinically significant; community based participatory research; community organizations; cost; cost effective; cost effectiveness; design; diabetes management; diabetic; effective intervention; effectiveness trial; empowered; ethnic minority population; experience; fasting glucose; follow-up; glycemic control; group intervention; health literacy; health related quality of life; high risk; improved; innovation; insight; intervention program; mortality; news; post intervention; programs; self help; skills; stem; translational study; transmission process; treatment as usual

DESCRIPTION (provided by applicant): The primary objective of this translational study is to conduct an effectiveness trial of a community-based glucose control intervention program for Korean American immigrants (KAI) with type-2 diabetes mellitus (DM). The self-help intervention program for Korean Americans ( SHIP-DM) focuses on the self-help aspect of DM control by empowering patients through enhanced knowledge of DM and diet, utilizing available technology to develop their ability for self -monitoring their glucose control status, facilitating better communication with their health care providers, and enhancing their health literacy and general problem-solving skills. The SHIP-DM has been developed and pilot tested through a "planning grant" mechanism via NIDDK (R34). Using a randomized experimental design (N=80) in our pilot study, we were able to demonstrate the efficacy and feasibility of the SHIP-DM with KAIs up to 6 months post-intervention. The final analysis suggested that the SHIP-DM was effective in both significantly lowering HbA1c and fasting glucose as well as in improving psychosocial variables in the sample: The reduction of HbA1c levels among intervention group participants (1.19% at 18 weeks and 1.31% at 30 weeks) were not only statistically significant but clinically meaningful, with 10%and 15% of the intervention group achieving the suggested goal of HbA1c < 7%. In comparison to the control group, the intervention group showed significant improvement in DM knowledge, self-care activities, DM-related self-efficacy, and their attitudes toward diabetes, depression, and quality of life. In addition, we became aware of the urgent need for disseminating effective interventions which are both linguistically and culturally tailored to KAI. As news of our study spread through media sources in the Korean ethnic community, we became inundated by requests from KAI families and community organizations (including the American Diabetes Association) for type-2 DM educational materials and culturally relevant interventions targeted toward KAI audiences. Because of the resource limitations of the pilot project, we were forced to turn away substantial numbers of KAI with type 2 DM who wanted to participate in our study. To address this critical need within the KAI community, we now propose to build upon our pilot work by conducting a two-phase clinical trial to test the effectiveness of the SHIP-DM in a larger sample of KAI and a longer follow-up (12months) while building important infrastructures for disseminating an array of intervention materials designed to address the health literacy and resources necessities for this vulnerable population. PUBLIC HEALTH RELEVANCE: This application proposes a randomized controlled trial of a community-based behavioral intervention in linguistically isolated Korean immigrants with type-2 DM with endpoint focus on the improvement of (1) glycemic control and BP control, (2) self-efficacy and self-help skills including health literacy skills, and (3) health related quality of life.

描述（由申请人提供）：这项翻译研究的主要目的是针对韩国美国移民（KAI）进行基于社区的葡萄糖控制干预计划的有效试验，该计划具有2型糖尿病（DM）。针对韩国美国人（Ship-DM）的自助干预计划通过增强对DM和饮食的知识来增强患者的能力，利用可用的技术来发展其自我监测的葡萄糖控制状态，促进与医疗保健提供者更好的沟通，并增强他们的健康识字能力和一般问题解决方案，从而提高了他们自我监控的能力，从而侧重于DM控制的自助方面。 船-DM已通过NIDDK（R34）开发并通过“计划赠款”机制进行了测试。在我们的试点研究中，使用随机实验设计（n = 80），我们能够证明船-DM在干预后长达6个月的船-DM的功效和可行性。最终分析表明，Ship-DM在显着降低HBA1C和空腹葡萄糖以及改善样本中的心理变量方面都是有效的： 干预组参与者中HBA1C水平的降低（18周时为1.19％，在30周时为1.31％）不仅具有统计学意义，而且具有临床意义，其中10％和15％的干预组实现了HBA1C <7％的建议目标。与对照组相比，干预组在DM知识，自我保健活动，与DM相关的自我效能感以及对糖尿病，抑郁症和生活质量的态度方面显示出显着改善。此外，我们意识到迫切需要传播有效的干预措施，这些干预措施既是语言和文化量身定制的）。随着我们研究的新闻通过韩国族裔社区的媒体来源传播，我们被KAI家族和社区组织（包括美国糖尿病协会）的要求淹没了，对2型DM教育材料以及针对KAI受众的文化相关干预措施。由于试点项目的资源限制，我们被迫拒绝大量的KAI，其中2型DM想要参加我们的研究。 为了满足KAI社区中的这一关键需求，我们现在建议通过进行两阶段的临床试验来建立我们的试点工作，以测试Ship-DM在较大的KAI样本和更长的后续行动（12个月）中的有效性，同时构建重要的基础设施，以构建旨在解决旨在解决这个识字素养和资源需求的众多干预材料的重要基础设施。 公共卫生相关性：本申请提出了一项基于社区的行为干预的随机对照试验，该试验具有2型DM语言孤立的韩国移民，端点侧重于改善（1）血糖控制和BP控制，（2）自我效能和自助技能，包括健康素养技能，以及（3）与健康相关的生活质量。