Implementation of a Culturally Tailored Diabetes Intervention With Community Health Workers in American Samoa
Implementation of a Culturally Tailored Diabetes Intervention With Community Health Workers in American Samoa
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DOI：
10.1177/0145721713504630
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发表时间：
2013-11-01
影响因子：
3.9
通讯作者：
McGarvey, Stephen T.
中科院分区：
文献类型：
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作者：
DePue, Judith D.;Rosen, Rochelle K.;McGarvey, Stephen T.
本文的目的是回答我们的翻译研究中的关键实施问题，以初级保健为基础，护士-社区卫生工作者（CHW）团队干预支持2型糖尿病自我管理。方法采用描述性数据分析干预方式、保健院就诊内容、患者安全、干预费用，并进行统计分析，探讨高出勤率的受试者特征。在干预样本（n = 104）中，74% （SD = 16%）的计划干预就诊在基于算法的方案指导下发生。高风险参与者的每周指定就诊剂量（66%）明显低于中度（74%）和低风险（90%）的参与者。28%的参与者在一年中转向了风险较低的群体。估计干预费用为每人656美元。受教育程度较低的参与者更有可能参加最佳比例的访问。结论护士- chw团队可以提供符合文化的糖尿病自我管理支持干预，并对基于算法的方案具有良好的保真度。团队通过随时随地满足参与者的需求来满足他们。这项研究提供了一个基于证据的模式适应萨摩亚文化背景及其资源贫乏环境的例子。
Purpose The purpose of this article is to answer key implementation questions from our translation research with a primary care-based, nurse-community health worker (CHW) team intervention to support type 2 diabetes self-management.Methods Descriptive data are given on intervention delivery, CHW visit content, patient safety, and intervention costs, along with statistical analyses to examine participant characteristics of higher attendance at visits.Results In the intervention sample (n = 104), 74% (SD = 16%) of planned intervention visits occurred, guided by an algorithm-based protocol. Higher risk participants had a significantly lower dose of their weekly assigned visits (66%) than those at moderate (74%) and lower risk (90%). Twenty-eight percent of participants moved to a lower risk group over the year. Estimated intervention cost was $656 per person. Participants with less education were more likely to attend optimal percentage of visits.Conclusions A nurse-CHW team can deliver a culturally adapted diabetes self-management support intervention with excellent fidelity to the algorithm-based protocols. The team accommodated participants' needs by meeting them whenever and wherever they could. This study provides an example of adaptation of an evidence-based model to the Samoan cultural context and its resource-poor setting.