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Resilience-Based Diabetes Self-Management Among African Americans

非裔美国人基于复原力的糖尿病自我管理

基本信息

批准号：
8238391
负责人：
Mary A. Steinhardt
金额：
$ 22.37万
依托单位：
UNIVERSITY OF TEXAS AT AUSTIN
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-03-15 至 2015-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8238391
关键词：
Address Adherence Adult Affect African American Behavior Belief Blood Pressure Cardiovascular Diseases Caring Choices and Control Chronic Disease Church Communities Diabetes Mellitus Diagnosis Dietitian Disease Education Educational Curriculum Educational Intervention Educational process of instructing Effectiveness Effectiveness of Interventions Emotional Emotional Stress Focus Groups Glycosylated Hemoglobin Glycosylated hemoglobin A Goals Grant Group Meetings Growth Guidelines Health Healthcare Healthy People 2010 Individual Informal Social Control Instruction Intervention Knowledge Life Life Style Long-Term Care Manuals Mental Depression Mentors Modeling Non-Insulin-Dependent Diabetes Mellitus Not Hispanic or Latino Nurses Obesity Outcome Participant Patients Personal Satisfaction Persons Pharmaceutical Preparations Physiological Pilot Projects Principal Investigator Randomized Clinical Trials Reporting Research Risk Factors Sampling Self Care Self Management Stress Stress and Coping Support Groups Testing Training Well in self Work Workplace base blood glucose regulation burden of illness community setting comparison group coping depressive symptoms diabetes educator diabetes management empowerment experience follow-up improved low socioeconomic status member programs psychologic psychosocial resilience response skills stressor theories

项目摘要

DESCRIPTION (provided by applicant): Type 2 diabetes affects more than 24 million people, and African Americans are disproportionately burdened by this disease. Diabetes is a psychologically and behaviorally demanding chronic disease. Individuals with diabetes typically experience greater stress than non-diseased individuals, and emotional stress worsens diabetes due to physiological effects on blood glucose regulation and reduction in adherence to diabetes self-care behaviors. Optimal long-term diabetes care requires an emotionally and mentally healthy patient - that is, a resilient patient. Most research, however, has focused on risk factors and adherence to diabetes management guidelines rather than enhancing psychosocial qualities that build resilient and thriving responses, enabling the patient to make healthy lifestyle choices and control the condition. This study uses the transactional model of stress and coping and self-regulation theory to address physical and emotional components of the disease, integrating a culturally competent resilience curriculum with diabetes self-management education. Aims are to: 1) further refine our resilience-based diabetes self-management education (RB-DSME) intervention and our RB-DSME participant workbook and facilitator instruction manual based on focus groups with key individuals from the target community; 2) determine the feasibility of offering the RB-DSME in community churches for African Americans diagnosed with type 2 diabetes using the refined participant workbook and facilitator manual; and 3) examine the intervention's effectiveness at 3 and 6 months post-study entry by comparing an experimental group who receive the RB-DSME intervention and a comparison group who receive standard diabetes self-management education (DSME). Three experimental and three comparison groups, each including eight weekly class sessions plus two follow-up bi-weekly support group meetings, will be taught by a certified diabetes educator (CDE) with 1-2 mentors in each group. Our working hypothesis is that both experimental and comparison group participants will show significant improvements in diabetes knowledge, but experimental group participants will show significantly greater improvements in psychological well-being, diabetes self-management behaviors, and physiological markers of obesity, type 2 diabetes, and CVD than the comparison group. Our long-term goal is to make our resilience curriculum accessible to African Americans with type 2 diabetes delivered by nurse or dietitian CDEs in broad community settings, enabling individuals to more effectively cope with stress and manage their type 2 diabetes in order to avoid its serious consequences. PUBLIC HEALTH RELEVANCE: Healthy People 2010 emphasizes that current diabetes programs are limited in their ability to produce and sustain changes in the behaviors of persons with diabetes. There is a critical need for interventions that provide diabetes self-management skills integrated with resilience and coping strategies so that patients can more effectively manage their stress, and thereby reduce the physiological burdens associated with this disease. Helping African Americans with type 2 diabetes to enhance their resilience may enable them to improve their long-term adherence to healthy lifestyle choices, thereby decreasing obesity and delaying the progression of type 2 diabetes.

描述（由申请人提供）：2型糖尿病影响超过2400万人，非洲裔美国人不成比例地负担这种疾病。糖尿病是一种对心理和行为要求很高的慢性疾病。患有糖尿病的个体通常比未患病的个体经历更大的压力，并且情绪压力由于对血糖调节的生理影响和对糖尿病自我护理行为的依从性的降低而使糖尿病恶化。最佳的长期糖尿病护理需要一个情绪和心理健康的病人-也就是说，一个有弹性的病人。然而，大多数研究都集中在风险因素和遵守糖尿病管理指南，而不是提高心理素质，建立弹性和蓬勃发展的反应，使患者能够做出健康的生活方式选择并控制病情。本研究采用压力和应对和自我调节理论的交易模型，以解决疾病的身体和情感成分，整合文化能力的韧性课程与糖尿病自我管理教育。目的是：1）进一步完善我们的糖尿病自我管理教育（RB-DSME）干预措施，以及我们的RB-DSME参与者工作手册和促进者指导手册，该手册基于目标社区关键人员的焦点小组; 2）使用完善的参与者工作手册和促进者手册，确定在社区教堂为被诊断患有2型糖尿病的非洲裔美国人提供RB-DSME的可行性;以及3）通过比较接受RB-DSME干预的实验组和接受标准糖尿病自我管理教育（DSME）的对照组，在研究进入后3个月和6个月检查干预的有效性。三个实验组和三个对照组，每组包括八个每周一次的课程，加上两个后续的双周支持小组会议，将由一名经过认证的糖尿病教育家（CDE）教授，每组有1-2名导师。我们的工作假设是，实验组和对照组参与者在糖尿病知识方面都有显着改善，但实验组参与者在心理健康，糖尿病自我管理行为以及肥胖，2型糖尿病和CVD的生理标志物方面的改善比对照组显着更大。我们的长期目标是使我们的韧性课程提供给非裔美国人与2型糖尿病由护士或营养师CDE在广泛的社区设置，使个人能够更有效地科普压力和管理他们的2型糖尿病，以避免其严重后果。公共卫生关系：2010年健康人强调，目前的糖尿病计划在产生和维持糖尿病患者行为变化的能力方面有限。迫切需要提供糖尿病自我管理技能的干预措施，这些技能与复原力和应对策略相结合，以便患者能够更有效地管理他们的压力，从而减少与这种疾病相关的生理负担。帮助患有2型糖尿病的非洲裔美国人提高他们的韧性，可能使他们能够长期坚持健康的生活方式选择，从而减少肥胖并延缓2型糖尿病的进展。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Positivity and indicators of health among African Americans with diabetes.

患有糖尿病的非裔美国人的积极性和健康指标。

DOI：
10.5993/ajhb.39.1.5
发表时间：
2015
期刊：
American journal of health behavior
影响因子：
2.3
作者：
Steinhardt,MaryA;Dubois,SusanK;Brown,SharonA;HarrisonJr,Louis;Dolphin,KathrynE;Park,Wonil;Lehrer,HMatthew
通讯作者：
Lehrer,HMatthew

A resilience intervention in African-American adults with type 2 diabetes.