Community-Based Diabetes Care for Korean American Immigrants

为韩裔美国移民提供社区糖尿病护理

• 批准号: 7918282
• 负责人: Miyong T Kim
• 金额: $ 66.16万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-20 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7918282
• 关键词: Address; Adult; Am 80; American; Asian Americans; Asians; Attitude; Behavior; Behavior Therapy; Behavioral; Caring; Case Management; Chronic Disease; Clinical Trials; Communication; Communities; Community Health; Control Groups; Counseling; Data; Diabetes Mellitus; Diet; Education; Educational Materials; Effectiveness; Experimental Designs; Family; Fostering; Generations; Glucose; Glycosylated hemoglobin A; Goals; Grant; Health; Health Insurance; Health Personnel; Health Services Accessibility; Healthcare; Hemoglobin; Home environment; Immigrant; Immigration; Intervention; Intervention Studies; Knowledge; Korean American; Koreans; Language; Lead; Medical; Mental Depression; Methodology; Minority; Minority Groups; Monitor; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Online Systems; Outcome; Participant; Patients; Phase; Pilot Projects; Population; Prevalence Study; Problem Solving; Process; Protocols documentation; Psychosocial Factor; Quality of life; Randomized; Randomized Controlled Trials; Reporting; Research; Research Infrastructure; Research Personnel; Resources; Risk; Sampling; Self Care; Self Efficacy; Social isolation; Source; Structure; System; Technology; Telephone; Terminology; Testing; Translating; Translational Research; Visual; Vulnerable Populations; Weight Gain; Work; base; blood glucose regulation; blood pressure regulation; checkup examination; clinically significant; community based participatory research; community organizations; cost; cost effectiveness; design; diabetes management; diabetic; effective intervention; effectiveness trial; empowered; ethnic minority population; experience; fasting glucose; follow-up; glycemic control; group intervention; health literacy; health related quality of life; high risk; improved; innovation; insight; intervention program; mortality; news; post intervention; programs; public health relevance; self help; skills; stem; translational study; transmission process; treatment as usual

DESCRIPTION (provided by applicant): The primary objective of this translational study is to conduct an effectiveness trial of a community-based glucose control intervention program for Korean American immigrants (KAI) with type-2 diabetes mellitus (DM). The self-help intervention program for Korean Americans ( SHIP-DM) focuses on the self-help aspect of DM control by empowering patients through enhanced knowledge of DM and diet, utilizing available technology to develop their ability for self -monitoring their glucose control status, facilitating better communication with their health care providers, and enhancing their health literacy and general problem-solving skills. The SHIP-DM has been developed and pilot tested through a "planning grant" mechanism via NIDDK (R34). Using a randomized experimental design (N=80) in our pilot study, we were able to demonstrate the efficacy and feasibility of the SHIP-DM with KAIs up to 6 months post-intervention. The final analysis suggested that the SHIP-DM was effective in both significantly lowering HbA1c and fasting glucose as well as in improving psychosocial variables in the sample: The reduction of HbA1c levels among intervention group participants (1.19% at 18 weeks and 1.31% at 30 weeks) were not only statistically significant but clinically meaningful, with 10%and 15% of the intervention group achieving the suggested goal of HbA1c < 7%. In comparison to the control group, the intervention group showed significant improvement in DM knowledge, self-care activities, DM-related self-efficacy, and their attitudes toward diabetes, depression, and quality of life. In addition, we became aware of the urgent need for disseminating effective interventions which are both linguistically and culturally tailored to KAI. As news of our study spread through media sources in the Korean ethnic community, we became inundated by requests from KAI families and community organizations (including the American Diabetes Association) for type-2 DM educational materials and culturally relevant interventions targeted toward KAI audiences. Because of the resource limitations of the pilot project, we were forced to turn away substantial numbers of KAI with type 2 DM who wanted to participate in our study. To address this critical need within the KAI community, we now propose to build upon our pilot work by conducting a two-phase clinical trial to test the effectiveness of the SHIP-DM in a larger sample of KAI and a longer follow-up (12months) while building important infrastructures for disseminating an array of intervention materials designed to address the health literacy and resources necessities for this vulnerable population. PUBLIC HEALTH RELEVANCE: This application proposes a randomized controlled trial of a community-based behavioral intervention in linguistically isolated Korean immigrants with type-2 DM with endpoint focus on the improvement of (1) glycemic control and BP control, (2) self-efficacy and self-help skills including health literacy skills, and (3) health related quality of life.

描述（由申请人提供）：本转化研究的主要目的是对患有2型糖尿病（DM）的韩裔美国移民（KAI）进行基于社区的血糖控制干预计划的有效性试验。韩裔美国人自助干预计划（SHIP-DM）侧重于糖尿病控制的自助方面，通过增强患者对糖尿病和饮食的认识，利用现有技术发展他们自我监测血糖控制状态的能力，促进与医疗保健提供者的更好沟通，提高他们的健康素养和一般问题解决能力。