A Community-Based, Culturally Tailored Behavioral Intervention for Korean Americans With Type 2 Diabetes

Abstract

Purpose-The purpose of this study is to test the efficacy of a culturally tailored comprehensive type 2 diabetes management intervention for Korean American immigrants (KAIs) with type 2 diabetes.Methods-A randomized controlled pilot trial with 2 parallel arms (intervention vs control) with a delayed intervention design was used. A total of 79 KAIs, recruited from the Baltimore-Washington area, completed baseline, 18-week, and 30-week follow-ups (intervention, n = 40; control, n = 39). All participants had uncontrolled type 2 diabetes (hemoglobin A1C ≥7.5%) at baseline. The authors' comprehensive, self-help intervention program for type 2 diabetes management (SHIP-DM) consisted of a 6-week structured psychobehavioral education, home glucose monitoring with teletransmission, and bilingual nurse telephone counseling for 24 weeks. The primary outcome of the study was A1C level, and secondary outcomes included an array of psychobehavioral variables.Results-Using analysis of covariance, the findings support that the proposed intervention was effective in significantly lowering A1C and fasting glucose and also in improving psychosocial outcomes in the sample. Specifically, the amount of reduction in A1C among intervention group participants was 1.19% at 18 weeks and 1.31% at 30 weeks, with 10% and 15.5% of the participants achieving the suggested goal of A1C <7% at 18 and 30 weeks of follow-up, respectively. Conclusions-The results highlight the clinical efficacy of the SHIP-DM intervention composed of a 6-week education program, self-monitoring, and follow-up counseling, in terms of maintaining the improved intervention effects obtained and in terms of glucose control.Type 2 diabetes mellitus is a serious health problem in Asian American communities, including the Korean American immigrant (KAI) community. KAIs, one of the most underserved and understudied minority populations in the United States, are at particularly high risk of developing type 2 diabetes. This risk is compounded by the fact that Asians who have emigrated to the West tend to gain weight and develop chronic diseases, including type 2 diabetes, after immigration. [1][2][3] Although studies of this new immigrant group are scare, available research has indicated that an overwhelming number of KAIs suffer not only from uncontrolled diabetes 4 but also from a loss of self-confidence and social isolation stemming from language and cultural barriers. 5 Researchers have found that currently available interventions for ethnic minority groups with type 2 diabetes are largely inadequate and ineffective because of insufficient integration of cultural framework and tailored strategies, which often results in suboptimal outcomes. [12][13][14][15][16] Today's KAIs, predominantly first-generation immigrants with strong ties to their traditional culture, are in great need of culturally relevant care. Integrating traditional diet and exercise and tailored counseling on pharmacological regimens based on their use of traditional herbal medicine and behavioral ...

Resilience in Vulnerable Populations With Type 2 Diabetes Mellitus and Hypertension: A Systematic Review and Meta-analysis

“…Five studies were pilot/feasibility studies 29,31,32,36,37 . Three studies targeted patients with hypertension 27,28,36 , thirteen described interventions in patients with diabetes 3,22–26,29,30,32–35,37 , and one study targeted patients with both conditions 31 (Online Table S1). …”

“…All but two studies 28,30 were aimed at low-income participants. These two studies targeted Korean Americans who had recently migrated to the US.…”

Psychosocial aspects of type 1 diabetes in Latino- and Asian-American youth

“…Culturally sensitive health interventions to improve T2D care and outcomes among the Latino and Asian adult populations have been tried, and shown to be effective, improving diabetes knowledge, self-efficacy, and glycemic control, while reducing the incidence of diabetic complications and controlling medical costs (143,144). Culturally sensitive diabetes interventions for Latinos and Asian Americans included bilingual educators, educational materials, and culturally identifiable focus groups (143,144).…”

“…Culturally sensitive diabetes interventions for Latinos and Asian Americans included bilingual educators, educational materials, and culturally identifiable focus groups (143,144). One study called "Every Little…”

Supporting implementation of evidence-based behavioral interventions: the role of data liquidity in facilitating translational behavioral medicine

“…health can benefit [3]. Examples of translational behavioral interventions that span these blocks have been presented elsewhere, such as the application of basic scientific understanding of diabetes and its management (T1) to develop behavioral interventions for diabetes self-management (T2) [4] and the cultural tailoring of these same interventions to most effectively reach identified populations in need (T3) [5].…”