PROMOTING "STORIES OF SUCCESS": ENHANCING DIABETES SELF-CARE

推广“成功故事”：加强糖尿病自我护理

• 批准号: 8167205
• 负责人: SHARON Williams UTZ
• 金额: $ 2.94万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8167205
• 关键词: Adult; Affect; African American; Age; Amputation; Behavioral; Blindness; Blood Glucose; Blood Pressure; Cardiovascular Diseases; Cardiovascular system; Case Manager; Clinical; Communities; Community Health; Complex; Computer Retrieval of Information on Scientific Projects Database; Control Groups; Data; Diabetes Mellitus; Disease; Education; Educational Intervention; End stage renal failure; Fibrinogen; Funding; Goals; Grant; Health; Health Professional; Institution; Intervention; Kidney Diseases; Link; Lipids; Lower Extremity; Measures; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Outcome; Physiological; Population; Prevalence; Problem Solving; Randomized Controlled Trials; Research; Research Personnel; Resources; Risk; Rural; Rural Community; Self Care; Self Management; Serum; Site; Source; Stroke; Testing; Treatment Efficacy; United States National Institutes of Health; Virginia; Waiting Lists; Work; base; efficacy testing; follow-up; glycemic control; group intervention; health disparity; intervention effect; programs; social cognitive theory; success; trend

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Type 2 diabetes mellitus (T2DM) is a serious health problem that disproportionately affects African Americans who have a nation-wide prevalence of 13.3% compared to 8.7% among adults overall. In rural Virginia, studies indicate that rates of diabetes mellitus (DM) are 15% among African American adults, with an even higher rate of 30% among those over age 60. T2DM among African Americans reflects the serious health disparities in the U.S. and is a leading cause of cardiovascular disease, stroke, blindness, end-stage renal disease, and non-traumatic lower limb amputations. A majority of adults with diabetes do not achieve recommended target levels of blood glucose, blood pressure and/or serum lipids, putting them at risk for complications such as cardiovascular and renal disease. African Americans have among the highest rates of complications and inadequate glycemic control. One factor limiting effective self-management is that less than half of adults receive comprehensive diabetes self-management education (DSME), considered essential to managing this complex disease. Recent studies show DSME programs that focus on problem-solving and goal setting are associated with improvements in clinical and behavioral outcomes. However, the kind of DSME program that is acceptable and effective for rural African Americans is unknown, because comprehensive DSME has rarely been available or culturally tailored to the population. This proposed study is a test of the feasibility of conducting a randomized-controlled trial and a preliminary test of the efficacy of a culturally-tailored community-based group DSME intervention on physiologic and behavioral outcomes. The approach will incorporate storytelling and compare results of the initial intervention group to a wait-list control group. Researchers will obtain preliminary data about outcome trends and the best measures for capturing effects of the intervention. The framework for the study is Social Cognitive Theory based on Afro-centric cultural norms. The intervention will include follow-up by a nurse case manager working closely with a community health worker who serves as a cultural and community link with the health professionals. The study site is a rural community known to researchers who conducted two preliminary studies in the community. Twenty-four African American adults will be followed during the two-year study to determine whether problem-focused DSME using storytelling is feasible and effective among rural African Americans, and will identify which measures are most useful for testing efficacy of the intervention for a full scale R-18 to be developed based on findings of this study.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 2 型糖尿病 (T2DM) 是一种严重的健康问题，对非裔美国人的影响尤为严重，其全国患病率为 13.3%，而成年人总体患病率为 8.7%。在弗吉尼亚州农村地区，研究表明非裔美国成年人的糖尿病 (DM) 发病率为 15%，60 岁以上人群的糖尿病发病率甚至更高，达到 30%。非裔美国人中的 T2DM 反映了美国严重的健康差距，是心血管疾病、中风、失明、终末期肾病和非创伤性下肢截肢的主要原因。大多数患有糖尿病的成年人没有达到推荐的血糖、血压和/或血脂目标水平，使他们面临心血管和肾脏疾病等并发症的风险。非裔美国人的并发症发生率和血糖控制不足是最高的。限制有效自我管理的一个因素是，不到一半的成年人接受了全面的糖尿病自我管理教育（DSME），这被认为对于管理这种复杂疾病至关重要。最近的研究表明，专注于解决问题和目标设定的 DSME 计划与临床和行为结果的改善相关。然而，哪种 DSME 计划对于农村非裔美国人来说是可接受且有效的，目前尚不清楚，因为很少有全面的 DSME 计划，也很少有针对该人群的文化定制。这项拟议的研究是对进行随机对照试验的可行性的测试，也是对基于文化的社区团体 DSME 干预对生理和行为结果的功效的初步测试。该方法将结合讲故事，并将初始干预组的结果与等待名单对照组的结果进行比较。研究人员将获得有关结果趋势的初步数据以及捕捉干预效果的最佳措施。该研究的框架是基于非洲中心文化规范的社会认知理论。干预措施将包括一名护士个案经理与一名社区卫生工作者密切合作的后续行动，社区卫生工作者充当与卫生专业人员的文化和社区纽带。研究地点是研究人员所熟知的一个农村社区，他们在该社区进行了两项初步研究。这项为期两年的研究将跟踪 24 名非裔美国成年人，以确定使用讲故事的以问题为中心的 DSME 在农村非裔美国人中是否可行和有效，并将确定哪些措施最有助于测试干预措施的有效性，以全面了解干预措施的效果。根据本研究的结果制定 R-18 量表。