Aims The purpose of this quasi-experimental one group longitudinal study is to examine the effects of a family-based intervention program on diabetes self-management behaviors, HbA1c, other biomarkers, psychosocial factors and health-related quality of life in Hispanics with diabetes. Methods Adult patients with diabetes (n = 36) and family members (n = 37) were recruited from a community clinic in rural central North Carolina. Patients and family members attended an 8-week culturally tailored diabetes educational program taught in Spanish. Data was collected pre and post intervention for both patients and family members, with an additional data collection for patients 1 month post intervention. Results Most patients and family members were female and almost all were immigrants. HbA1c dropped by 0.41% on average among patients from pre-intervention to 1 month post intervention. Patients showed significant improvements in systolic blood pressure, diabetes self-efficacy diabetes knowledge, and physical and mental components of health-related quality of life. Higher levels of intake of healthy foods and performance of blood sugar tests and foot inspections were reported. Family members significantly lowered BMI and improved diabetes knowledge from pre- to immediate post-intervention. No significant changes in levels of physical activity were found among patients with diabetes or family members. Conclusions Findings suggest that including family members in educational interventions may provide emotional and psychological support to patients with diabetes, help to develop healthy family behaviors, and promote diabetes self-management.

Hispanics show poorer self-management of type 2 diabetes than non-Hispanic Whites. Although previous studies have reported socioeconomic and cultural barriers to diabetes self-management by Hispanics, little is known about perceived barriers to diabetes self-management from the perspectives of both Hispanics and their family members. Purpose The purpose of the study was to explore perceived barriers among Hispanic immigrants with diabetes and their family members. Methods A qualitative study using five focus groups was conducted. A total of 73 Hispanic immigrants with type 2 diabetes (n=36) and family members (n=37) were recruited in the southeastern United States for a family-based intervention study of diabetes-self management. Participants were asked to describe their perceptions of barriers to self-management. The five sessions were audiotaped and transcribed, translated from Spanish into English, and analyzed using standard content analysis. Demographics, hemoglobin A1C levels, blood pressure and BMI were obtained both for participants with diabetes and for their family members. Results Barriers to diabetes self-management themes identified by participants with diabetes were in three major themes categorize: suffering from diabetes, difficulties in managing the disease, and lack of resources/support. Two key themes emerged pertaining to family members: we can provide support and we lack knowledge. Conclusions Perceived barriers to diabetes self-management described by Hispanic immigrants with diabetes and family members indicate a lack of intervention strategies to meet their needs. Interventions should include culturally relevant resources, family support, and diabetes self-management skills education.

Purpose The purpose of this study was to test efficacy of a family-based, culturally tailored intervention for Hispanics with type 2 diabetes and their family members. Methods Hispanic patients with type 2 diabetes and their family members recruited from community clinics and ethnic churches were assigned to groups (N=186). The intervention group received an 8-week culturally tailored diabetes educational program delivered in Spanish while the attention control group received 8-week sessions on general health information and two sessions on diabetes after completion of the study. Data were collected at baseline, after intervention and at 1- and 6-month follow-ups for both patients and families. Comparisons of change over time were performed using growth curve analyses after propensity score adjustment. Results Intervention patients improved in diabetes knowledge and diabetes self-efficacy over time (but did not sustain at 6-month follow-up). A1C was lower at 1-month follow-up. Family members had improvements in diabetes knowledge and physical health-related quality of life. Conclusions Including families in the interventions may improve glycemic control, diabetes knowledge, self-efficacy and physical health-related quality of life. However, strategies for sustaining improvements are need.

Purpose The purpose of this study was to explore the meaning of insulin among a sample of Hispanic immigrants with type 2 diabetes and their family members/significant others. Methods Forty-three Hispanics with type 2 diabetes and their family members/significant others were recruited in the southeastern United States for a family-based intervention study on diabetes-self management. Focus groups were conducted in which participants with diabetes and family members were asked to describe their perceptions of insulin. The sessions were audiotaped and transcribed, translated from Spanish into English and analyzed using standard content analysis. This paper reports the findings, as well as demographic information and hemoglobin A1C levels of participants. Results The meaning of insulin was described by both Hispanic immigrants with type 2 diabetes and their family members/significant others. Participants’ perceptions were categorized into three major themes: (1) negative perceptions of insulin therapy, (2) perceived barriers to insulin therapy, and (3) positive experiences with insulin emerged from qualitative data. Conclusions The Hispanic immigrants with diabetes and their family members/significant others in this study described perceptions and fears of insulin indicating a lack of understanding of the diabetes disease process and the progressive nature of diabetes. Strategies and further research are necessary to dispel negative perceptions and facilitate positive experiences with insulin for patients, and family members/significant others.

The purpose of this study was to conduct focus groups with Hispanic patients with type 2 diabetes and their family members who participated in a culturally tailored, family-based diabetes intervention about their action plans for a healthier lifestyle. Methods Five separate focus groups were led in Spanish by an experienced bicultural/bilingual moderator. The audiotaped sessions occurred at the end of the 8-week diabetes educational program. Data were transcribed in Spanish and translated into English. Qualitative content analysis was used to analyze the findings. Results Eighty-four Hispanic adults participated with an equal representation of patients with diabetes and family members. Most persons were female (63.1%) and the majority of persons were born in Mexico. The mean (SD) age of participants was 44.2 (14.3) years. Six themes emerged from the data: healthier eating habits, increasing physical activity, taking care of my sugar, coping with emotions, for the family, and empowerment and increased selfefficacy. Conclusions Hispanics created action plans that promoted healthier lifestyle behaviors individually and as a family. This type 812478T DEXXX10.