Outcomes from a Diabetes Self-management Intervention for Native Hawaiians and Pacific People: Partners in Care

Abstract

Background Culturally-adapted interventions are needed to reduce diabetes-related morbidity and mortality among Native Hawaiian and Pacific People. Purpose To pilot test the effectiveness of a culturally-adapted diabetes self-management intervention. Methods Participants were randomly assigned in an unbalanced design to the Partners in Care intervention (n=48) or wait list control group (n=34). Assessments of hemoglobin A1c, understanding of diabetes self-management, performance of self-care activities, and diabetes-related distress were measured at baseline and 3 months (post intervention). Analysis of covariance was used to test between-group differences. The community steering committee and focus group data informed the cultural adaptation of the intervention. Results There were significant baseline adjusted differences at 3 months between the Partners in Care and wait list control group in intent-to-treat (p<0.001) and complete case analyses (p<0.0001) for A1c, understanding (p<0.0001), and performing diabetes self-management (p<0.0001). Conclusions A culturally-adapted diabetes self-management intervention of short duration was an effective approach to improving glycemic control among Native Hawaiian and Pacific Islanders.

A Systematic Review: Family Support Integrated To Diabetes Self-Management among Glycemic Uncontrolled Type II DM Patients

“…Some studies conducted the diabetes self-management education with mix teaching methods by involving the family members into a collaborative approach (12,14,15,17,20,21) . The combination of didactic with other methods such as goal setting, action plan and problem solving has a positive impact on health outcomes and improve health behaviors (13,(17)(18)(19)(20)(21)23) .…”

“…A bluetooth technology was incorporated to deliver the diabetes information (12) . Four studies used food model, picture, illustration, foot picture (14,18,20,24) . Diabetes handout/booklet (diet, exercise, medication, eye, and foot self-care) been used to spread the knowledge (15,16,19,21,30,32,36) .…”

“…Three studies were noticed to follow-up the program by using the telephone method (13,14,25,26,32) . Mix of telephone and face-to-face follow-up strategies (18)(19)(20)29) and two studies did not mention about the follow-up process for evaluating the program (16,21) …”

“…DSME is also reported to improve HbA1c level by as much as 1% among glycemic uncontrolled patients. (12,15,18,19,21,22,24,32,33) . In addition, several outcomes have a positive effect on psychosocial (35) , self-efficacy (14,24) , dietary and physical behavior aspects (19) , perceived support (15) , knowledge (32) , medication adherence and quality of life (32) .…”

“…Those studies confirmed that higher level of support is significantly influencing the blood glucose monitoring at home (13,14,17,20,24,34) . For medication taking behavior, seven studies demonstrated that regularly medication adherence was conducted under the family support (14,15,(18)(19)(20)(21) . Furthermore, this review confirmed that the increasing of self-awareness on foot inspections is correlated to foot ulcer prevention (13,34) .…”