Self Care Interventions for Black Women with Type 2DM

描述(由申请者提供)：黑人女性体验最高之一 2型糖尿病(DM)的发病率，并不成比例地患有 糖尿病相关并发症。糖尿病现在是导致糖尿病的第二大原因 黑人女性的死亡。这通常可以归因于糖尿病控制不力。 由于糖尿病护理不达标以及缺乏糖尿病教育和 自我管理能力。这项研究的目的是在美国黑人女性中 2型糖尿病是为了评估一种经过测试的、对文化敏感的 糖尿病教育、应对技能培训(CST)与糖尿病干预 护理旨在改善血糖控制，并使他们能够 承担自我管理所需的知识和技能。这项研究是专门设计的 目的：(1)确定实验性干预对血糖的影响 控制，特别是血红蛋白Alc，通过比较它与对照组 基线、3、6、9、12、24和36个月的常规护理；(2)确定 体重(BMI)、血脂水平、血压与原发性高血压的关系 血糖控制的结果；以及(3)确定 糖尿病自我管理与自我效能感的实验干预 生活质量。患有2型糖尿病的黑人女性(N=129)将随机分为1组 两组：(1)6周文化敏感型认知-行为糖尿病 教育计划，随后进行5周的CST和糖尿病护理访问，或(2) 5周标准糖尿病教育计划的常规护理，每周5次 由患者发起的讨论会议和糖尿病护理访问。关爱将是 两组相同，并将基于一致的治疗算法 使用ADA护理指南。对文化敏感的教育计划将是 在高级实习护士的带领下，接受了使用该计划的培训。护士 来自合作初级保健中心的医生和医生团队将 看望所有受试者进行护理访问。数据将在基线3、6、9、 12个月、24个月和36个月。我们假设接受实验的女性 干预措施将显著改善血糖控制，并将 通过糖尿病自我管理和质量显著提高自我效能 与接受传统糖尿病教育和护理的妇女相比，妇女的生活质量更高。 针对每个研究目标的数据分析将使用ANOVA和 多元回归。这项研究的发现将有益于健康 美国黑人妇女的结局，她们通常由初级保健照顾 在各种医疗保健环境中的提供者，在类型2的整个轨迹中 DM。卫生保健机构，特别是初级保健中心，将受益于 一种经过测试的糖尿病护理模式干预，将改善糖尿病 结果，并有助于减轻个人和公共卫生负担 这种疾病。

DESCRIPTION (provided by applicant): Black women experience one of the highest rates of type 2 diabetes mellitus (DM) and suffer disproportionately from diabetes related complications. Diabetes is now the second leading cause of death among black women. This can be attributed to poor diabetes control often due to sub-standard diabetes care and lack of diabetes education and self-management skills. The purpose of this study in black American women with type 2 DM is to evaluate the effect of a tested, culturally sensitive intervention of diabetes education, coping skills training (CST), and diabetes care designed to improve glycemic control and to empower them with the knowledge and skills necessary to assume self-management. The study is designed to: (1) determine the effect of the experimental intervention on glycemic control, specifically Hemoglobin Alc, by comparing it to a control group of conventional care at baseline, 3, 6, 9, 12, 24 and 36 months; (2) to determine the relationship of weight (BMI), lipid levels, blood pressure and the primary outcome of glycemic control; and (3) to determine the effect of the experimental intervention on self-efficacy with diabetes self-management and quality of life. Black women (N=129) with type 2 DM will be randomized to one of two groups: (1) a 6 week culturally sensitive cognitive-behavioral diabetes education program, followed by 5 weeks of CST and diabetes care visits, or (2) conventional care of a 5 week standard diabetes education program, 5 weekly patient-generated discussion sessions and diabetes care visits. Care will be the same for both groups and will be based on a treatment algorithim consistent with ADA care guidelines. The culturally sensitive education program will be led by advanced practice nurses trained in use of the program. Nurse practitioner and physician teams from collaborating primary care centers will see all subjects for care visits. Data will be collected at baseline 3, 6, 9, 12, 24, and 36 months. We hypothesize that women who receive the experimental intervention will have significantly better glycemic control, and will have significantly greater self-efficacy with diabetes self-management and quality of life compared to women receiving conventional diabetes education and care. Data analysis specific to each study aim will be conducted using ANOVA and multiple regression. The findings from this study will benefit the health outcomes of black American women, who most often are cared for by primary care providers, in various health care settings throughout the trajectory of type 2 DM. Health care settings, particularly primary care centers, will benefit from a tested, model intervention of diabetes care that will improve diabetes outcomes and contribute to decreasing the personal and public health burden of the disease.