Design of a randomized, controlled, comparative-effectiveness trial testing a Family Model of Diabetes Self-Management Education (DSME) vs. Standard DSME for Marshallese in the United States.
Design of a randomized, controlled, comparative-effectiveness trial testing a Family Model of Diabetes Self-Management Education (DSME) vs. Standard DSME for Marshallese in the United States.
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DOI：
10.1016/j.conctc.2017.03.007
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发表时间：
2017-06
影响因子：
1.5
通讯作者：
McElfish PA
中科院分区：
文献类型：
--
作者：
Kim Yeary KH;Long CR;Bursac Z;McElfish PA
2型糖尿病(T2D)是一个重大的公共卫生问题，美国太平洋岛民社区--如马绍尔人--承受着不成比例的负担。使用以社区为基础的参与式方法(CBPR)，利用马绍尔社区强大的以家庭为基础的社会基础设施，是管理T2D的一种有前途的方法。在社区-学术合作伙伴关系的领导下，糖尿病自我管理教育家庭模式(DSME)旨在通过让整个家庭参与，改变糖尿病管理行为，以改善马绍尔成人T2D患者的血糖控制。为了检验DSME的家庭模型，对240名主要参与者进行了一项随机、对照、相对有效性试验。一半的主要参与者被随机分配到标准DSME，另一半被随机分配到家庭模型DSME。双方都收到了10个小时的内容，其中包括6-8次会议，时间为6-8周。家庭模式DSME是对DSME的文化适应，干预的重点是为T2D的主要参与者提供家庭支持。标准DSME以社区为基础的小组形式提供给主要参与者。主要参与者和参与的家庭成员在基线和干预后立即进行评估，并将在6个月和12个月时进行评估。DSME家系模式旨在通过T2D改善马绍尔人的血糖控制。利用让当地利益攸关方参与的CBPR办法以及马绍尔社区以家庭为基础的社会基础设施的参与，增加了干预的成功和可持续性的潜力。
Type 2 diabetes (T2D) is a significant public health problem, with U.S. Pacific Islander communities—such as the Marshallese—bearing a disproportionate burden. Using a community-based participatory approach (CBPR) that engages the strong family-based social infrastructure characteristic of Marshallese communities is a promising way to manage T2D. Led by a collaborative community-academic partnership, the Family Model of Diabetes Self-Management Education (DSME) aimed to change diabetes management behaviors to improve glycemic control in Marshallese adults with T2D by engaging the entire family. To test the Family Model of DSME, a randomized, controlled, comparative effectiveness trial with 240 primary participants was implemented. Half of the primary participants were randomly assigned to the Standard DSME and half were randomly assigned to the Family Model DSME. Both arms received ten hours of content comprised of 6–8 sessions delivered over a 6–8 week period. The Family Model DSME was a cultural adaptation of DSME, whereby the intervention focused on engaging family support for the primary participant with T2D. The Standard DSME was delivered to the primary participant in a community-based group format. Primary participants and participating family members were assessed at baseline and immediate post-intervention, and will also be assessed at 6 and 12 months. The Family Model of DSME aimed to improve glycemic control in Marshallese with T2D. The utilization of a CBPR approach that involves the local stakeholders and the engagement of the family-based social infrastructure of Marshallese communities increase potential for the intervention's success and sustainability.