Developing a Diabetes Numeracy Intervention for American Indians/Alaska Natives

为美洲印第安人/阿拉斯加原住民制定糖尿病算术干预措施

• 批准号: 8508620
• 负责人: Angela Gwen Brega
• 金额: $ 20.75万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-10 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8508620
• 关键词: Address; Adult; Affect; Age; American Indian and Alaska Native; Behavior; Blood Glucose; Blood Glucose Self-Monitoring; Carbohydrates; Cardiovascular Diseases; Clinical; Clinical Research; Colorado; Communities; Comprehension; Development; Diabetes Mellitus; Diagnosis; Dietary Practices; Disease; Doctor of Philosophy; Dose; Education; Educational Curriculum; Educational process of instructing; Endocrine System Diseases; Food Labeling; Foundations; Goals; Health; Health care facility; Hypertension; Income; Individual; Insulin; Intervention; Knowledge; Link; Literature; Medication Management; Metabolic Diseases; Minority Groups; National Institute of Diabetes and Digestive and Kidney Diseases; Native-Born; Not Hispanic or Latino; Outcome; Participant; Patients; Pharmaceutical Preparations; Population; Populations at Risk; Poverty; Prevalence; Publishing; Randomized Controlled Trials; Reading; Recruitment Activity; Reporting; Research; Research Personnel; Research Project Grants; Resources; Risk; Sampling; Science; Self Care; Self Efficacy; Self Management; Testing; Time; Training; Universities; Visit; Work; base; design; diabetes management; effective intervention; experience; follow-up; glycemic control; health literacy; improved; innovation; insight; public health relevance; secondary outcome; skills; statistics; therapy design

DESCRIPTION (provided by applicant): Developing a Diabetes Numeracy Intervention for American Indians/Alaska Natives Project Summary Patients with diabetes must engage in a variety of self-care behaviors, including appropriate dietary practices, blood glucose self-monitoring, and medication management. Important to each of these behaviors is the capacity to understand and use numbers (e.g., counting carbohydrates). Referred to as "numeracy," such abilities are associated with a variety of diabetes self-care behaviors and outcomes (e.g., glycemic control). Although the prevalence of diabetes has raised nationwide, American Indians and Alaska Natives (AI/ANs) are diagnosed with diabetes at 2-3 times the rate of non-Hispanic Whites. And, yet, Native people are at risk for limitations in the numerical skills that are criticl for diabetes management. Although deficits in numeracy are widespread, such limitations are particularly common among racial/ethnic minorities and individuals with limited income and education. As a result of restricted educational opportunities and high rates of poverty in many AI/AN communities, Native people with diabetes are at risk for limitations in diabetes-related numeracy. Despite evidence of a link between numeracy and health, no interventions aimed at improving health- related numeracy have been published. The goal of the proposed project is to develop and pilot test an intervention to improve diabetes-related numerical skills among AI/ANs with diabetes. The aims of the project are the following: (1) To develop a culturally appropriate intervention to teach the numerical skills required for successful diabetes self-management; (2) To assess change in numeracy skills following intervention; and (3) To explore change in diabetes self-efficacy, self-care behavior, and clinical outcomes following intervention and to assess whether change in numeracy predicts change in these secondary outcomes. The INTervention to Enhance Numeracy in Diabetes (INTEND) will be adapted from two existing numeracy curricula - Extending Mathematical Power (EMPower) and Statistics for Action (SfA) - which were developed to teach adults the math skills needed to manage everyday numerical tasks. The project team, which includes experts in AI/AN health and diabetes numeracy as well as the developers of EMPower and SfA, will adapt these curricula to address diabetes management among AI/ANs. The INTEND will be tested in a randomized controlled trial involving 130 AI/AN patients with diabetes from Yakama Indian Health Center in Toppenish, WA. Analyses will assess whether patients who participate in the INTEND show significantly greater improvement in numeracy, self-efficacy, self-care behavior, and clinical outcomes than do control patients. As no interventions designed to improve health-related numeracy have been reported in the literature, this innovative project will advance science related to numeracy and highlight a new avenue for intervening with AI/ANs and other populations at risk for diabetes and its complications. As similar numerical skills are required in the management of other serious health problems, such as cardiovascular disease and hypertension, the results of this work may inform the development of effective interventions for other conditions as well.

描述（由申请人提供）：为美国印第安人/阿拉斯加原住民开发糖尿病数字干预项目摘要糖尿病患者必须进行各种自我护理行为，包括适当的饮食习惯，血糖自我监测和药物管理。对这些行为中的每一个都很重要的是理解和使用数字的能力（例如，计算碳水化合物）。这种能力被称为“计算能力”，与各种糖尿病自我护理行为和结果相关（例如，血糖控制）。 虽然糖尿病的患病率在全国范围内有所上升，但美洲印第安人和阿拉斯加原住民（AI/AN）被诊断患有糖尿病的比率是非西班牙裔白人的2-3倍。然而，土著人在糖尿病管理方面面临着数字技能限制的风险。虽然计算能力的缺陷很普遍，但这种限制在少数种族/族裔和收入和教育有限的个人中特别常见。由于许多AI/AN社区的教育机会有限和贫困率高，患有糖尿病的土著人面临与糖尿病相关的算术能力受限的风险。 尽管有证据表明计算能力和健康之间存在联系，但尚未公布旨在改善与健康相关的计算能力的干预措施。拟议项目的目标是开发和试点测试一种干预措施，以改善患有糖尿病的AI/AN中与糖尿病相关的数字技能。该项目的目标如下：（1）制定文化上适当的干预措施，教授成功自我管理糖尿病所需的数字技能;（2）评估干预措施后数字技能的变化;探讨糖尿病患者自我效能、自我护理行为、以及干预后的临床结局，并评估计算能力的变化是否可预测这些次要结局的变化。 INTEND将改编自两个现有的计算课程-扩展数学能力（EMPower）和行动统计（SfA）-这是为了教成年人管理日常数字任务所需的数学技能而开发的。该项目团队包括AI/AN健康和糖尿病计算专家以及Empower和SfA的开发人员，将调整这些课程以解决AI/AN中的糖尿病管理问题。INTEND将在一项随机对照试验中进行测试，该试验涉及来自华盛顿州Toppenish的Yakama Indian Health Center的130例AI/AN糖尿病患者。分析将评估参加INTEND的患者在计算能力、自我效能、自我护理行为和临床结局方面是否比对照患者有显著更大的改善。 由于文献中没有报道旨在改善健康相关算术能力的干预措施，因此这一创新项目将推动与算术相关的科学发展，并强调干预AI/AN和其他糖尿病及其并发症风险人群的新途径。由于在其他严重健康问题（如心血管疾病和高血压）的管理中也需要类似的数字技能，因此这项工作的结果也可以为其他疾病的有效干预措施的制定提供信息。