The primary objective of this study is to develop an innovative glucose control intervention program for Korean American immigrants (KAI) with type 2 diabetes mellitus (DM) that is culturally sensitive, built on valid behavioral theory and principles, and enhances the control of glucose level and promotes health related quality of life. Specifically, we focus on the self-help aspect of DM control by empowering patients with better knowledge about DM and DM diet, facilitating better communication with their health care providers, and enhancing their general problem-solving skills. We propose to undertake a pilot project to design and evaluate the efficacy of self-help glucose control intervention program specially designed for KAI with type 2 DM. This self-help intervention will have 3 concurrently administered components: (1) a structured psycho-behavioral education intervention that focuses on fostering self-help skills in managing DM; (2) home glucose monitoring with a telephone transmission system (HGMT); and (3) interaction with a bilingual nurse case manager who will facilitate effective communication between KAI with type 2 DM and their care providers.
Our specific aims are to: (1) refine an intervention protocol that specifies the process and content of the self-help intervention for KAI with type 2 DM; (2) enroll 80 KAI (>= 30 years of age) with type 2 DM in greater Baltimore-Washington area and randomly assign 40 KAI to the self-help intervention program, which will consist of 3 components: a psycho-behavioral DM education program delivered in community settings, home glucose monitoring with an HGMT device for 30 weeks, and frequent communication with a bilingual nurse case manager; and (3) measure the effect of the self-help intervention program on glucose control and psycho-behavioral outcomes, including self-efficacy, problem-solving skills, and adherence to treatment recommendations, in comparison to usual care. The proximal (self-care behaviors of glucose control, enabling skills, and self-help) and distal (glucose control and health-related quality of life) outcome variables will be measured before the intervention (week 0) and at 18 and 30 weeks after the start of the intervention. Insights gained in this pilot investigation should help us to develop effective, culturally sensitive self-help protocols for wider application to KAI with type 2 DM in metropolitan areas throughout the U.S. ? ?
