A Feasibility Study of a Culturally Tailored Diabetes Intervention for Mexican Americans

Abstract

Latinos, the fastest growing minority group in the United States, are among the hardest hit by diabetes. Among Latinos, Mexican Americans have the highest rate (23.9%) of diabetes. Good self-management can improve glycemic control and decrease diabetes complications but can be challenging to achieve. The purpose of this study was to test the feasibility and examine the effects of a culturally tailored intervention for Mexican Americans with type 2 diabetes on outcomes of self-management. The study used a pretest/posttest control group design with 10 participants in each group (N = 17). Feasibility and acceptability of the tailored diabetes self-management program was assessed by examining ease of recruitment and retention rates. The behavioral outcomes of self-efficacy, diabetes knowledge and self-care measures, and the biologic outcomes of weight, body mass index, HbA1C, and blood glucose were used to examine intervention effectiveness. Successful recruitment of participants came from personal referrals from providers or the promotora. Retention rates were 100% for the intervention group and 80% for the control group. Findings suggest that the intervention had a positive clinical and statistical effect on diabetes knowledge, weight, and body mass index. Improvements were also noted in self-efficacy scores, blood glucose, and HbA1C, but these changes did not reach statistical significance. A culturally tailored diabetes self-management program may result in improved outcomes for Mexican Americans with type 2 diabetes.

The Impact of Arab American Culture on Diabetes Self-management Education

“…11 The impact of culture on DSME is likely more significant among less acculturated Arab Americans because lack of acculturation in this population has been linked to higher risk of dysglycemia. 12 Culturally specific DSME interventions have been developed and evaluated among several different racial and ethnic groups, including African Americans, 13,14 Latinos and Mexican Americans, 15,16 Chinese Americans, 17 and Hawaiian Asian Pacific Islanders. 18 Findings suggest that culturally tailored interventions are effective at improving health outcomes [13][14][15][16][17] and increasing engagement in healthy DSM behaviors.…”

Factors that promote and prohibit access to participants in the clinical setting: A review of response rates from a health communication intervention study

“…For example, in research by Caipke et al [11] and Carballo et al [14] self-referral techniques (e.g., participants contacting researchers after seeing advertisements) were successful in studies of depression [11] and addiction [14] while provider referrals resulted in few to no participants. Provider referrals, however, have been successful in studies of disease states such as diabetes [9], cancer [10,20], and Alzheimer disease [21]. For some studies, the role of the physician in patient participant recruitment can be critical to accrual goal success.…”

“…For some studies, the role of the physician in patient participant recruitment can be critical to accrual goal success. Research shows that many patients are willing to participate because they are referred to the project by their physicians [9] and that physicians can be a substantial obstacle to patient access if physicians believe the study may harm or unduly burden participants [21,22]. Second, it is essential to minimize the amount of participant burden.…”

“…Several studies have investigated a number of recruitment strategies with mixed success. Recruitment strategies discussed in the literature include advertisements (TV, radio, newspapers, Internet) [14][15][16], posters [14,15], brochures [15], direct mailings [15], health center or provider referrals [6,9,14], recruitment through community agencies [4][5][6]13,17], and snowball techniques [14,18]. There is not, however, a consensus regarding which strategy or strategies are the best.…”

“…Underrepresentation in research and the subsequent impact of underrepresentation of priority populations on the generalizability of results are of great concern. Consequently, researchers have focused recruitment efforts on strategies to reach priority populations such as minority groups (e.g., African Americans [3][4][5][6][7][8], Latinos [9,10]), individuals with specific diseases (e.g., diabetes [3,6], depression [11], cancer [10], HIV [12]), and/or individuals with key characteristics (e.g., women from lowincome, rural communities [13], older adults [11]). …”