An Academic-Community Engagement: A Roadmap for Developing a Culturally Relevant Diabetes Self-Management Program among Vietnamese Americans

Nguyen, Anna; Jones, Emily J.; O’Neal, Katherine S.; Netter, Molly K.; Dwyer, Kathleen

doi:10.33596/coll.104

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…The SMart-D intervention was developed with substantial engagement with the Vietnamese community of Oklahoma, including leaders of the Asian District Cultural Association, faith-based leaders, health care professionals, and people with T2D. This 23-member group served as an advisory board for over a 1-year period and highlighted the need to develop a feasible and appropriate study design as well as the need to incorporate language and culture-relevant information [29]. By incorporating the Health Belief Model, this SMart-D intervention emphasized the need to reduce diabetes complication risks and motivated participants to take into account the central concept of risk, thus encouraging health behavior change [30].…”

Section: Patient and Public Involvement In Intervention Developmentmentioning

confidence: 99%

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study

Nguyen,

Nagykaldi,

Bui

et al. 2023

JMIR Res Protoc

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Background Evidence indicates participation in a diabetes self-management education and support program improves self-care behaviors and hemoglobin A1c. Language and cultural differences may be barriers to program participation resulting in ineffective self-management, but these factors can be addressed with appropriate interventions. Given the high health care costs associated with diabetes complications, we developed a multicomponent, culturally tailored Self-Management Mobile Health Intervention for US Vietnamese With Diabetes (SMart-D). Objective This study aims to evaluate the SMart-D intervention’s feasibility, acceptability, and effectiveness with intentions to scale up the intervention in the future. This mixed methods study incorporates the Reach, Effectiveness, Adoption, Implementation, Maintenance framework to evaluate the intervention. Methods This stepped wedge randomized controlled pilot study will be conducted over 2 years in collaboration with primary care clinics. Eligible participants are patients with type 2 diabetes who are receiving health care from participating clinics. Clinics will be randomly assigned to an implementation date and will begin with patients enrolling in the control period while receiving standard care, then cross over to the intervention period where patients receive standard care plus the SMart-D intervention for over 12 weeks. Focus groups or interviews will be conducted with clinicians and patients after study completion. Qualitative data will be analyzed using NVivo. Outcomes on self-care behavior changes will be measured with the Summary of Diabetes Self-Care Activities scale and clinical changes will be measured using laboratory tests. A generalized linear mixed-effect model will be used to compute time effect, clustering effect, and the interaction of the control and intervention periods using SAS (version 9.4; SAS Institute). Results We hypothesize that (1) at least 50% (n=5) of eligible clinics and 50% (n=40) of eligible patients who are invited will participate, and at least 70% (n=56) of patients will complete the program, and (2) patients who receive the intervention will have improved self-care behaviors and clinical test results with at least 75% (n=60) of the patients maintaining improved outcomes at follow-up visits compared with baseline, and participants will verbalize that the intervention is feasible and acceptable. As of August 2023, we enrolled 10 clinics and 60 patients. Baseline data results will be available by the end of 2023 and outcome data will be published in 2025. Conclusions This is the first Vietnamese diabetes self-management education and support intervention that leverages mobile health technology to address the barriers of language and culture differences through collaboration with primary care clinics. This study will provide a better understanding of the implementation process, demonstrate the potential effectiveness of the intervention, accelerate the pace of moving evidence-based interventions to practice among the US Vietnamese population, and potentially provide a replicable implementation model that can be culturally adapted to other non-English speaking ethnic minorities. International Registered Report Identifier (IRRID) DERR1-10.2196/48585

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Section: Patient and Public Involvement In Intervention Developmentmentioning

confidence: 99%

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study

Nguyen,

Nagykaldi,

Bui

et al. 2023

JMIR Res Protoc

View full text Add to dashboard Cite

show abstract

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study (Preprint)

Nguyen¹,

Nagykáldi²,

Bui³

et al. 2023

Preprint

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BACKGROUND Evidence indicates participation in a diabetes self-management education and support program improves self-care behaviors and hemoglobin A1c. Language and culture differences may be barriers to program participation resulting in ineffective self-management, but these factors can be addressed with appropriate interventions. Given the high healthcare costs associated with diabetes complications, we developed a multicomponent, culturally tailored Self-Management mHealth Intervention for US Vietnamese with Diabetes (SMart-D). OBJECTIVE To describe a pilot study protocol that evaluates the SMart-D intervention feasibility, acceptability, and effectiveness with intentions to scale up the intervention in the future. This mixed-method study incorporates the RE-AIM framework to evaluate reach, effectiveness, adoption, implementation, and maintenance of the intervention. METHODS This stepped wedge randomized controlled pilot study will be conducted over 2 years in collaboration with primary care clinics. Eligible participants are patients with type 2 diabetes and are receiving healthcare from participating clinics. Clinics will be randomly assigned to an implementation date and will begin with patients enrolling in the control period while receiving standard care, then cross over to the intervention period where patients receive standard care plus the SMart-D intervention over 12 weeks. Focus groups/interviews will be conducted with clinicians and patients after study completion. Qualitative data will be analyzed using NVivo. Outcomes on self-care behavior changes will be measured with the Summary of Diabetes Self-Care Activities scale and clinical changes will be measured using laboratory tests. A generalized linear mixed effect model will be used to compute time effect, clustering effect, and the interaction of the control and intervention periods using SAS 9.4. RESULTS We hypothesize that (a) at least 50% of eligible clinics and 50% of eligible patients who are invited will participate, and at least 75% of patients will complete the program; (b) patients who receive the intervention will have improved self-care behaviors and clinical test results with at least 75% of the patients will maintain improved outcomes at follow-up visits compared with baseline, and participants will verbalize that the intervention is feasible and acceptable. As of April 2023, we enrolled 10 clinics and 34 patients. Baseline data results will be available by end of 2023 and outcomes data will be published in 2025. CONCLUSIONS This is the first Vietnamese DSMES intervention that leverages mHealth technology to address the barriers of language and culture differences through collaborating with primary care clinics. This study will provide a better understanding of the implementation process, demonstrate the potential impact of the intervention, accelerate the pace of moving evidence-based interventions to practice among US Vietnamese population, and potentially provide a replicable implementation model that can be culturally adapted to other non-English speaking ethnic minorities.

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An Academic-Community Engagement: A Roadmap for Developing a Culturally Relevant Diabetes Self-Management Program among Vietnamese Americans

Cited by 2 publications

References 21 publications

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study

mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study (Preprint)

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