Self Care Interventions for Black Women with Type 2DM

描述（由申请人提供）：黑人妇女经历的最高之一 2型糖尿病（DM）的发病率， 糖尿病相关并发症糖尿病现在是第二大原因 黑人女性的死亡这可以归因于糖尿病控制不佳， 由于不达标的糖尿病护理和缺乏糖尿病教育， 自我管理能力。这项研究的目的是在美国黑人妇女与 2型糖尿病是为了评估测试的效果，文化敏感， 糖尿病教育、应对技能培训（CST）和糖尿病干预 护理旨在改善血糖控制，并赋予他们 承担自我管理所需的知识和技能。本研究设计 目的：（1）确定实验干预对血糖的影响 对照组，特别是血红蛋白Alc，通过将其与 基线、3、6、9、12、24和36个月时的常规护理;（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;和（3）确定 糖尿病自我管理与自我效能的实验干预 生活质量患有2型糖尿病的黑人女性（N=129）将被随机分配到一个 两组：（1）6周文化敏感的认知行为糖尿病 教育计划，随后进行5周CST和糖尿病护理访视，或（2） 常规护理5周标准糖尿病教育计划，每周5次 患者自发的讨论会和糖尿病护理访问。护理将是 两组相同，并将基于一致的治疗算法 ADA护理指南文化敏感的教育计划将是 由接受过该计划培训的高级实习护士领导。护士 来自合作初级保健中心的从业者和医生团队将 对所有受试者进行护理访视。将在基线3、6、9、10、11、12、13、14、15、16、18、19、1 12、24和36个月。我们假设接受实验性药物的女性 干预将有显着更好的血糖控制， 糖尿病自我管理和质量的自我效能显著提高 与接受传统糖尿病教育和护理的女性相比， 将使用ANOVA进行每个研究目标的特定数据分析， 多元回归这项研究的结果将有益于健康 美国黑人妇女的结果，谁最经常照顾的初级保健 提供者，在整个2型糖尿病的轨迹中的各种医疗保健环境中， DM.卫生保健机构，特别是初级保健中心，将受益于 一个经过测试的糖尿病护理干预模型，将改善糖尿病 结果，并有助于减少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.