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.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
5R18DK083936-03
Application #
8103859
Study Section
Special Emphasis Panel (ZDK1-GRB-1 (M1))
Program Officer
Garfield, Sanford A
Project Start
2009-08-20
Project End
2014-06-30
Budget Start
2011-07-01
Budget End
2012-06-30
Support Year
3
Fiscal Year
2011
Total Cost
$608,862
Indirect Cost
Name
Johns Hopkins University
Department
Miscellaneous
Type
Schools of Nursing
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Ko, Jisook; Kim, Kim B; Timmerman, Gayle M et al. (2017) Factors Predicting Sodium Intake of Korean Americans with Type 2 Diabetes. J Immigr Minor Health :
Kim, Miyong To; Kim, Kim Byeng; Ko, Jisook et al. (2017) Role of depression in diabetes management in an ethnic minority population: a case of Korean Americans with type 2 diabetes. BMJ Open Diabetes Res Care 5:e000337
Kim, Kim B; Kim, Miyong T; Lee, Hochang B et al. (2016) Community Health Workers Versus Nurses as Counselors or Case Managers in a Self-Help Diabetes Management Program. Am J Public Health 106:1052-8
Kim, Miyong T; Kim, Kim B; Huh, Boyun et al. (2015) The Effect of a Community-Based Self-Help Intervention: Korean Americans With Type 2 Diabetes. Am J Prev Med 49:726-737
Kim, Kim B; Han, Hae-Ra; Huh, Boyun et al. (2014) The effect of a community-based self-help multimodal behavioral intervention in Korean American seniors with high blood pressure. Am J Hypertens 27:1199-208
Kim, Hyerang; Song, Hee-Jung; Han, Hae-Ra et al. (2013) Translation and validation of the dietary approaches to stop hypertension for koreans intervention: culturally tailored dietary guidelines for Korean Americans with high blood pressure. J Cardiovasc Nurs 28:514-23
Kim, Miyong T; Han, Hae-Ra; Song, Hee-Jung et al. (2009) A community-based, culturally tailored behavioral intervention for Korean Americans with type 2 diabetes. Diabetes Educ 35:986-94