Hispanics are underserved and less likely to take advantage of health education activities than their non-Hispanic White counterparts. We propose to continue the work we have done with community partners in a community-based participatory research (CBPR) project to reduce the diabetes health disparities experienced by Hispanics in a rural area. Our Community Advisory Board (CAB) has worked closely with the research institution (FHCRC) to plan and implement a pilot project on diabetes. Early in the project, the CAB funded small community-initiated research projects to identify the best pilot project that was feasible for this study. It has assisted in developing an evaluation plan, both for the pilot project, and for the CBPR aspect of the study. The CAB has worked diligently on preparing the project for this intervention research phase, where it plans to conduct a larger, randomized study to test the intervention. Toward that end, the specific aim of this proposal is to test the efficacy of an intervention to educate diabetics and pre-diabetics about the management of diabetes. In this project, we will continue our CBPR project with the Lower Yakima Valley of Washington. We will work closely with our CAB to test an intervention where Hispanic individuals with diabetes or pre-diabetes receive in-home intervention for managing their diabetes with their family members and/or relatives and friends. Diabetes information will be delivered through """"""""home health parties,"""""""" guided discussions in the individual's home. A trained promotora, or lay health educator, is invited to go into the home and present a four-session guided discussion on diabetes. The discussion is facilitated by sets of flip charts that were developed and revised in the planning phase of this grant. Individuals in the the study are given a baseline questionnaire on diabetes factors, eating behavior, physical activity, family history, and sociodemographic factors, then randomized to receive an immediate intervention, or are waitlisted to receive an intervention three months hence;this delayed intervention serves as control. The primary outcome of the intervention is changes in A1c levels three months after randomization. A secondary outcome is change in knowledge of diabetes. A process evaluation will be conducted to ascertain fidelity of the intervention. An evaluation of the CBPR process will also be conducted at two points throughout the trial: midway through intervention and at the end of data collection.
|Shepherd-Banigan, Megan; Hohl, Sarah D; Vaughan, Catalina et al. (2014) ""The Promotora Explained Everything"": Participant Experiences During a Household-Level Diabetes Education Program. Diabetes Educ 40:507-515|
|Duggan, Catherine; Carosso, Elizabeth; Mariscal, Norma et al. (2014) Diabetes prevention in Hispanics: report from a randomized controlled trial. Prev Chronic Dis 11:E28|
|Livaudais, Jennifer C; Thompson, Beti; Islas, Ilda et al. (2010) Type 2 diabetes among rural Hispanics in Washington State: perspectives from community stakeholders. Health Promot Pract 11:589-99|
|Ceballos, Rachel M; Coronado, Gloria D; Thompson, Beti (2010) Having a diagnosis of diabetes is not associated with general diabetes knowledge in rural Hispanics. J Rural Health 26:342-51|