Hispanics with type 2 diabetes show poorer self-management ofthe disease than non-Hispanic Whites. Interventions that have emphasized the individual's role in disease management have shown limited effectiveness for Hispanics. Because ofthe strong emphasis on family and the importance of family support systems within Hispanic culture, addressing family influences on diabetes management may result in improved health by creating a more informed and supportive context. Therefore, the specific aim of this study is to test the efficacy of an 8-week intervention for Hispanics with type 2 diabetes and their family members. The experimental group (n=39 participants with diabetes and n=39 family members) will participate in a program designed to improve diabetes self-management, glycemic control.family support and health-related quality of life. Eight weekly interactive modules for the experimental group have been modified from a family based diabetes program reflecting the National Standards for Diabetes Self-Management Education and the National Diabetes Education Program. Modules will be tailored to integrate cultural beliefs and values and will be adapted for low literacy levels. An attention control group of participants with diabetes (n=39) and their family members (n=39) will receive 8 sessions on general health information. Participants will be recruited at Hispanic-serving diabetes clinics and churches. Data will be collected on all participants at baseline (family session), post intervention (family session), 1 month and 6 months after the intervention. Participants will complete questionnaires on diabetes knowledge, family support, diabetes self-efficacy, diabetes self-care activities, physical activity, diet and health-related quality of life. Anthropometric measures will include height, weight, waist circumference, lipids, AlC and blood pressure. Multilevel models (mixed effect repeated measures) will be fit to the data to test hypotheses and estimate the magnitude of differences between the groups. The proposed culturally specific family-based intervention has the potential to reach our long-term objective, which is to enhance diabetes self-management, achieve optimal glycemic control and reduce complications more frequently associated with diabetes among the Hispanic population.
The proposed culturally specific family-based intervention strategies can help health educators and providers improve diabetes self-management and glycemic control among Hispanic American adults with type 2 diabetes and their family members and thus help reduce health disparities for Hispanic Americans.
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