Community-Based Intervention to Improve Diabetes Outcomes in Older African American Women with Multi-Caregiving Burden
以社区为基础的干预措施,以改善承担多重护理负担的老年非洲裔美国妇女的糖尿病结局
基本信息
- 批准号:10409770
- 负责人:
- 金额:$ 19.37万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-08-11 至 2024-05-31
- 项目状态:已结题
- 来源:
- 关键词:18 year oldAddressAdultAdult ChildrenAfrican AmericanAfrican American populationAgeAgingAngerBehaviorBlood GlucoseCaringCessation of lifeChildCommunitiesComplications of Diabetes MellitusCoping SkillsDataDiabetes MellitusDietDiet HabitsDistressElderlyElementsEmotionalEnd stage renal failureFinancial HardshipFocus GroupsFrustrationFutureGenerationsGlycosylated hemoglobin AGoalsHealthHigh PrevalenceHousehold HeadsInterventionLiteratureMeasuresMetabolic ControlMonitorMorbidity - disease rateMotivationNon-Insulin-Dependent Diabetes MellitusNursesOphthalmic examination and evaluationOutcomeParentsParticipantPersonsPhysical activityPopulationPrevalenceProblem SolvingQuality of lifeRandomizedRiskSF-12Self CareSocial isolationStressStructureStudy SectionSymptomsTelephone InterviewsTestingTimeTraining and EducationUnited StatesVisual impairmentWomanWorkbasebehavior changeblood pressure controlblood pressure reductionburden of illnesscare giving burdencaregivingdesigndiabetes educationeffective interventionexperiencefeasibility testingfootglucose monitorglycemic controlgrandparentimprovedimproved outcomeinner cityintervention mappingmedication compliancemortalitymulti-component interventionneglectnovelpeer supportrecruitskills trainingstress reductionstressortreatment adherencetreatment as usualuptake
项目摘要
PROJECT SUMMARY/ABSTRACT
African Americans (AA) with type 2 diabetes (T2DM) have a higher prevalence of diabetes, poorer
metabolic control, and greater risk for complications and death compared to Whites. AA Women (AAW) have a
higher rate of diabetes, higher prevalence of visual impairment, higher rate of end-stage renal disease, and
higher age-adjusted mortality rate compared to White women. While the reasons for higher diabetes-related
morbidity and mortality in AAW have not been clearly elucidated, multi-caregiving responsibilities, or the
provision of care (emotional, physical/tangible, financial, spiritual) to parents/grandparents,
children/grandchildren, significant others, and their larger community, is a significant barrier to effective
diabetes care and contributes to the higher disease burden and increased mortality in AAW with T2DM. This is
particularly true for AAW in the Sandwich Generation (adults in their 40s and 50s who are wedged between
elderly parents and adult children/grandchildren), and the Club Sandwich Generation (adults in their 50s and
60s, who are wedged between aging parents/grandparents, adult children, and grandchildren), where multi-
caregiving responsibilities have resulted in increased stress, poorer glycemic control, and suboptimal self-care
behaviors. In addition, there is limited evidence on effective interventions that address multi-caregiving burden
in inner city AAW with T2DM. Preliminary data from our group suggests that a community-based, nurse-
facilitated, group-based, peer-support intervention that incorporates storytelling, problem solving and
goal setting, coping strategies, and diabetes education and skills training may be effective in this
population. Therefore, we propose a pilot randomized study to test the feasibility and preliminary efficacy of a
novel, community-informed, multicomponent intervention on mitigating stressors associated with multi-
caregiving responsibilities to improve diabetes outcomes compared to diabetes enhanced usual care. The
long-term goal of the project is to identify effective strategies for improving metabolic control and reducing
diabetes complications and mortality rates in AAW with T2DM.
项目总结/摘要
患有2型糖尿病(T2 DM)的非洲裔美国人(AA)的糖尿病患病率较高,
代谢控制,并发症和死亡的风险更大。AA妇女(AAW)有一个
糖尿病发病率较高,视力损害患病率较高,终末期肾病发病率较高,
与白色女性相比,年龄调整后的死亡率更高。虽然与糖尿病相关的高血糖的原因
AAW的发病率和死亡率尚未明确阐明,多重责任,或
向父母/祖父母提供照顾(情感、身体/有形、经济、精神),
子女/孙辈、重要的其他人及其更大的社区,是有效实施的重大障碍。
糖尿病护理,并导致AAW伴T2 DM患者的疾病负担更高和死亡率增加。这是
尤其是三明治一代的AAW(40多岁和50多岁的成年人,
老年父母和成年子女/孙辈),以及俱乐部三明治一代(50多岁的成年人和
60岁的人,夹在年迈的父母/祖父母、成年子女和孙子孙女之间),
过度的责任感会导致压力增加、血糖控制不佳和自我护理欠佳
行为。此外,关于解决多重生育负担的有效干预措施的证据有限。
患有2型糖尿病我们小组的初步数据表明,一个以社区为基础的护士-
促进,以小组为基础,同伴支持干预,包括讲故事,解决问题,
目标设定、应对策略、糖尿病教育和技能培训可能对此有效
人口因此,我们建议进行一项试点随机研究,以测试的可行性和初步疗效,
新的,社区知情的,多成分干预,以减轻与多因素相关的压力,
与糖尿病相比,改善糖尿病结局的责任增强了常规护理。的
该项目的长期目标是确定有效的策略,以改善代谢控制和减少
AAW合并T2 DM患者的糖尿病并发症和死亡率。
项目成果
期刊论文数量(7)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Intersection of Structural Racism, Social Determinants of Health, and Implicit Bias With Emergency Physician Admission Tendencies.
- DOI:10.1001/jamanetworkopen.2021.26375
- 发表时间:2021-09-01
- 期刊:
- 影响因子:13.8
- 作者:Egede LE;Walker RJ;Williams JS
- 通讯作者:Williams JS
Nonmedical Interventions For Type 2 Diabetes: Evidence, Actionable Strategies, And Policy Opportunities.
- DOI:10.1377/hlthaff.2022.00236
- 发表时间:2022-07
- 期刊:
- 影响因子:9.7
- 作者:Egede, Leonard E.;Walker, Rebekah J.;Linde, Sebastian;Campbell, Jennifer A.;Dawson, Aprill Z.;Williams, Joni S.;Ozieh, Mukoso N.
- 通讯作者:Ozieh, Mukoso N.
Gender invariance in the relationship between social support and glycemic control.
- DOI:10.1371/journal.pone.0285373
- 发表时间:2023
- 期刊:
- 影响因子:3.7
- 作者:Williams, Joni S.;Walker, Rebekah J.;Egede, Leonard E.
- 通讯作者:Egede, Leonard E.
Integrating Medical and Social Care to Reduce Diabetes Inequities: Lessons from the Bridging the Gap Program.
整合医疗和社会护理以减少糖尿病不平等:弥合差距计划的经验教训。
- DOI:10.1007/s11606-022-07977-5
- 发表时间:2023
- 期刊:
- 影响因子:5.7
- 作者:Williams,JoniS;Walker,RebekahJ;Peek,MonicaE;Chin,MarshallH
- 通讯作者:Chin,MarshallH
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Joni Strom Williams其他文献
Joni Strom Williams的其他文献
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{{ truncateString('Joni Strom Williams', 18)}}的其他基金
The Role of Structural Racism on Disparities in Clinical Outcomes for Diabetes: A Mixed Methods Study
结构性种族主义对糖尿病临床结果差异的作用:混合方法研究
- 批准号:
10634279 - 财政年份:2023
- 资助金额:
$ 19.37万 - 项目类别:
Community-Based Intervention to Improve Diabetes Outcomes in Older African American Women with Multi-Caregiving Burden
以社区为基础的干预措施,以改善承担多重护理负担的老年非洲裔美国妇女的糖尿病结局
- 批准号:
10057597 - 财政年份:2020
- 资助金额:
$ 19.37万 - 项目类别:
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