Mexican Americans are affected by type 2 diabetes at twice the rate of non-Hispanic Whites and they suffer higher rates of diabetes-related complications. Because Mexican Americans are more likely to lack health insurance or access to medical care, many may depend solely on self-evaluation and self-management of diabetes and its symptoms. The proposed study uses a repeated measures experimental design to determine the feasibility of delivering a culturally-specific intervention focusing on diabetes symptom self-management for Mexican Americans, examine preliminary measures of the intervention's effectiveness and costs, and assess participants' perceptions of the intervention. The proposed intervention is both standardized and tailored to participants' unique symptoms. Participants in the experimental condition will receive 8 weekly in-home 90-minute interactive one-on-one educational and behavior modification sessions with a registered nurse focusing on symptom awareness, glucose self- testing, and subsequent appropriate treatment (weeks 1 8) and 8 biweekly follow-up support telephone calls (weeks 10 24). A wait-listed control group (WLC) will serve as a comparison for the intervention group at all data points. Participants in the WLC will be offered the home-based portion of the intervention beginning in week 26. A total of 72 Mexican American adults, aged 25-75, with type 2 diabetes will participate in the study (36 in each group). The feasibility and costs of conducting the home-based intervention will be evaluated using process evaluation and basic cost analyses. Data to assess the effects of the intervention (including symptom- related knowledge, glucometer use, physiologic indicators of health: glycosylated hemoglobin, blood pressure, weight, lipids, confidence in diabetes self-management, and quality of life) will be collected from participants in both intervention and WLC groups at three points: baseline (week 0), immediately post- intervention (week 9), and 120 days post-intervention (week 25) to examine long-term effects of the intervention on A1c levels. Intervention participants' perceptions about the intervention will be evaluated using focus groups.
The proposed study provides an essential public health service by pilot testing a symptom-focused, culturally meaningful, diabetes self-management program aimed at reducing barriers to lifestyle modification, increasing health literacy, improving diabetes control and quality of life, and relieving the physical, societal, and economic burdens of Mexican Americans' worsening diabetes prevalence and consequences. ? ? ?
| García, Alexandra A; Zuñiga, Julie A; Lagon, Czarina (2017) A Personal Touch: The Most Important Strategy for Recruiting Latino Research Participants. J Transcult Nurs 28:342-347 |
| Garcia, Alexandra A; Zuniga, Julie; Reynolds, Raquel et al. (2015) Evaluation of the spoken knowledge in low literacy in diabetes scale for use with Mexican Americans. J Transcult Nurs 26:279-86 |
| García, Alexandra A; Brown, Sharon A; Horner, Sharon D et al. (2015) Home-based diabetes symptom self-management education for Mexican Americans with type 2 diabetes. Health Educ Res 30:484-96 |
