This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.This study is being conducted at an outpatient clinic that serves primarily low-income members of ethnic minorities, including Marshallese, who suffer greatly from the effects of poorly controlled diabetes mellitus Type 2 (DM 2). The study will assess the effect of a modified group lifestyle intervention program on parameters highly correlated with morbidity and mortality from DM 2, including HgbA1c, lipids, blood pressure (BP), weight, and quality of life (QOL). We hypothesize that these cost-effective interventions will lead to health improvements in the study population. Marshallese diabetics are a group which is both understudied, and greatly devastated by the impact of their disease. If group education, conducted in a cost effective manner by Resident Physicians, can improve health parameters, and quality of life, this would greatly serve the health of the Marshallese community on Oahu, and can be exported to the Marshall Islands, where diabetes-related illnesses are the leading cause of mortality. If effective, this project could lead to other studies in other underserved diabetic populations, and serve as a model for other Primary Care Residency Programs or large group practices for improving the health care of their patients with DM 2 in a cost-effective and culturally sensitive manner. A lifestyle intervention with emphasis on group membership and activity, with culturally appropriate modifications might be especially effective in cultures which value group membership, as is seen in most Asian-Pacific cultures.

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