Informing a Randomized Control Trial in Rural Populations: Adaptation of a Diabetes Self-Management Education and Support Intervention.
Informing a Randomized Control Trial in Rural Populations: Adaptation of a Diabetes Self-Management Education and Support Intervention.
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DOI：
10.2196/35664
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发表时间：
2022-06-10
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影响因子：
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通讯作者：
Litchman, Michelle
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作者：
Oser, Tamara K;Zittleman, Linda;Curcija, Kristen;Kwan, Bethany;Burke, Shawnecca;Gonzalez, Sindy;Huss, Kelsey;Johnson, Marilee;Sanchez, Norah;Neuberger, Julie;Iacob, Eli;Simonetti, Juliana;Litchman, Michelle
美国有超过3400万人患有糖尿病，每年有150万人被诊断出糖尿病。糖尿病自我管理教育和支持（DSMES）是治疗延迟或预防并发症的重要组成部分。农村社区在获得DSMES方面面临着许多独特的挑战，包括地理障碍和文化上适应农村环境的DSMES计划的可用性。靴子营翻译（BCT）是一种基于社区的参与式研究的既定方法，用于将复杂的临床和科学信息转化为社区成员和患者可理解、有意义和相关的概念、信息和材料。本研究旨在利用BCT来调整现有的DSMES计划，以便在农村初级保健中为讲英语和西班牙语的糖尿病患者提供服务。高平原研究网络（HPRN）社区咨询理事会（C.A.C.）与科罗拉多大学和犹他州大学的研究人员合作，使用BCT帮助翻译现有DSMES项目中的医学术语和材料，称为"糖尿病一天（D1D）"。BCT由C.A.C.在6个月内举行的10次虚拟会议组成，其中包括15个不同的社区利益攸关方。英语和西班牙语-英语双语C.A.C.招募成员是为了反映经调整的方案将在哪些农村社区实施。BCT过程指导了D1D在农村环境中的应用（R-D1D）。R-D1D适应反映了内容和交付，以确保干预措施是适当的，并可能被农村讲英语和西班牙语的糖尿病患者接受。此外，BCT为招聘和方案材料的设计以及招聘地点的确定提供了信息。在BCT过程中，确定了剪裁材料以反映英语和西班牙语患者文化差异的重要性。BCT是学术研究人员与农村社区成员合作的有效策略，以适应现有的DSMES干预措施，在农村地区向讲英语和西班牙语的糖尿病患者提供服务。通过BCT，对招聘材料和方法、方案内容和交付以及补充材料进行了调整。与会者强调，需要在利益攸关方的投入下对西班牙文材料进行文化改编，而不是简单地将材料翻译成西班牙文。确定了提高对糖尿病与抑郁症或糖尿病痛苦之间联系的认识的重要性，包括当地食物的适应性，以及糖尿病患者与其初级保健实践之间关系的重要性。
Over 34 million people in the United States have diabetes, with 1.5 million diagnosed every year. Diabetes self-management education and support (DSMES) is a crucial component of treatment to delay or prevent complications. Rural communities face many unique challenges in accessing DSMES, including geographic barriers and availability of DSMES programs that are culturally adapted to rural context. Boot Camp Translation (BCT) is an established approach to community-based participatory research used to translate complex clinical and scientific information into concepts, messages, and materials that are understandable, meaningful, and relevant to community members and patients. This study aimed to utilize BCT to adapt an existing DSMES program for delivery in rural primary care for English- and Spanish-speaking people with diabetes. The High Plains Research Network (HPRN) Community Advisory Council (C.A.C.) partnered with researchers at the University of Colorado and University of Utah to use BCT to aid in translating medical jargon and materials from an existing DSMES program, called “Diabetes One Day (D1D).” BCT consisted of 10 virtual meetings over a 6-month period among the C.A.C., which included 15 diverse community stakeholders. Both English-speaking and bilingual Spanish-English–speaking C.A.C. members were recruited to reflect the diversity of the rural communities in which the adapted program would be delivered. The BCT process guided adaptations to D1D for use in rural settings (R-D1D). R-D1D adaptations reflect both content and delivery to assure that the intervention is appropriate and likely to be accepted by rural English- and Spanish-speaking people with diabetes. Additionally, BCT informed the design of recruitment and program materials and identification of recruitment venues. During the BCT process, the importance of tailoring materials to reflect culture differences in English- and Spanish-speaking patients was identified. BCT was an effective strategy for academic researchers to partner with rural community members to adapt an existing DSMES intervention for delivery in rural areas to both English- and Spanish-speaking patients with diabetes. Through BCT, adaptations to recruitment materials and methods, program content and delivery, and supplemental materials were developed. The need to culturally adapt Spanish materials with input from stakeholders rather than simply translate materials into Spanish was highlighted. The importance of increasing awareness of the connection between diabetes and depression or diabetes distress, adaptations to include local foods, and the importance of the relationship between people with diabetes and their primary care practices were identified.