Diabetes Care in American Samoa

美属萨摩亚的糖尿病护理 摘要 随着美国2型糖尿病患病率的增加，糖尿病福尔斯的负担更多地落在群体身上 在护理方面存在更大的障碍，如语言和文化差异，以及经济资源较低。 《2010年健康人民》将糖尿病列为消除种族和民族健康的六种疾病之一 差距。这些差距延伸到美属萨摩亚，那里的成年人比例 2002年，18岁以上的糖尿病患者占19.6%，而美国成年人为6.4%。未报告 美国萨摩亚人的糖尿病干预措施。这个应用程序的总体目的是翻译最近的 通过改进方法，在美属萨摩亚社区的糖尿病护理临床实践中取得进展 改善糖尿病自我管理的方法。我们将利用社区 卫生工作者模型，以测试扩展的糖尿病护理模型。社区卫生工作者（CHW） 经常被用来作为卫生保健服务和贫困少数民族患者之间的“桥梁”， 社区.卫生保健工作者提供文化上适当的卫生教育和有益的社会支持 和便利，甚至组织，获得护理，同时也提供病人的信息，以医疗 提供商我们建议进行一项临床试验，以测试CHW和初级保健协调的有效性。 为352名2型糖尿病患者及其家属提供外展、教育和支持， 美属萨摩亚。一年随访的结果将包括糖化血红蛋白（HbA1c）， 心血管疾病危险因素、饮食和锻炼行为以及对糖尿病护理指南的依从性。 该干预措施建立在糖尿病护理的最佳临床实践基础上，通过将有效的策略转化为 美属萨摩亚人良好的糖尿病护理在那里的翻译可能提供一个模式， 可在其他患有糖尿病的少数民族人群中复制。

Diabetes Care in American Samoa Abstract As type 2 diabetes prevalence increases in the United States, the burden of diabetes falls more on groups with greater barriers to care, such as language and cultural differences, and lower economic resources. Healthy People 2010 targeted diabetes as one of six diseases for the elimination of racial and ethnic health disparities. These disparities extend to the US Territory of American Samoa, where the proportion of adults >18 years with diabetes was 19.6% in 2002, compared to 6.4% of US adults. There have been no reported diabetes interventions in Samoans in the US. The overall purpose of this application is to translate recent advances in diabetes care into clinical practice for the American Samoan community by improving methods of health care delivery and improve methods of diabetes self management. We will use the community health worker model to test an expanded diabetes care model. Community health workers (CHW) have frequently been used to serve as "bridges" between health care services and patients in poor ethnic minority communities. CHW workers provide culturally appropriate health education and instrumental social support and facilitation, and even organization, of access to care, while also providing patient information to medical providers. We propose a clinical trial to test the effectiveness of a CHW and primary-care coordinated intervention to provide outreach, education and support to 352 type 2 diabetes patients and their families in American Samoa. The outcomes at a one-year follow-up will include glycosolated hemoglobin (HbA1c), cardiovascular disease risk factors, diet and exercise behaviors, and adherence to diabetes care guidelines. The intervention builds upon best clinical practices for diabetes care by translating effective strategies to American Samoans. The translation of good diabetes care there may offer a model that is potentially replicable in other ethnic minority populations suffering the burden of diabetes.