Community-Based Intervention to Improve Diabetes Outcomes in Older African American Women with Multi-Caregiving Burden

以社区为基础的干预措施，以改善承担多重护理负担的老年非洲裔美国妇女的糖尿病结局

• 批准号: 10057597
• 负责人: Joni Strom Williams
• 金额: $ 20.77万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-11 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10057597
• 关键词: 18 year old; Address; Adult; Adult Children; African American; Age; Aging; Anger; Behavior; Blood Glucose; Caring; Cessation of life; Child; Communities; Complications of Diabetes Mellitus; Data; Diabetes Mellitus; Diet; Diet Habits; Distress; Elderly; Elements; Emotional; End stage renal failure; Financial Hardship; Focus Groups; Frustration; Future; Generations; Glycosylated hemoglobin A; Goals; Health; High Prevalence; Household Heads; Intervention; Literature; Measures; Metabolic Control; Monitor; Morbidity - disease rate; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Ophthalmic examination and evaluation; Outcome; Parents; Participant; Physical activity; Population; Prevalence; Problem Solving; Quality of life; Randomized; Risk; SF-12; Self Care; Social isolation; Stress; Structure; Study Section; Symptoms; Telephone Interviews; Testing; Time; Training and Education; United States; Visual impairment; Woman; Work; base; behavior change; blood pressure reduction; blood pressure regulation; burden of illness; care giving burden; caregiving; coping; design; diabetes education; effective intervention; experience; foot; glucose monitor; glycemic control; grandparent; improved; improved outcome; inner city; medication compliance; mortality; multi-component intervention; neglect; novel; peer support; recruit; skills training; stress reduction; stressor; treatment adherence; treatment as usual; uptake

PROJECT SUMMARY/ABSTRACT African Americans (AA) with type 2 diabetes (T2DM) have a higher prevalence of diabetes, poorer metabolic control, and greater risk for complications and death compared to Whites. AA Women (AAW) have a higher rate of diabetes, higher prevalence of visual impairment, higher rate of end-stage renal disease, and higher age-adjusted mortality rate compared to White women. While the reasons for higher diabetes-related morbidity and mortality in AAW have not been clearly elucidated, multi-caregiving responsibilities, or the provision of care (emotional, physical/tangible, financial, spiritual) to parents/grandparents, children/grandchildren, significant others, and their larger community, is a significant barrier to effective diabetes care and contributes to the higher disease burden and increased mortality in AAW with T2DM. This is particularly true for AAW in the Sandwich Generation (adults in their 40s and 50s who are wedged between elderly parents and adult children/grandchildren), and the Club Sandwich Generation (adults in their 50s and 60s, who are wedged between aging parents/grandparents, adult children, and grandchildren), where multi- caregiving responsibilities have resulted in increased stress, poorer glycemic control, and suboptimal self-care behaviors. In addition, there is limited evidence on effective interventions that address multi-caregiving burden in inner city AAW with T2DM. Preliminary data from our group suggests that a community-based, nurse- facilitated, group-based, peer-support intervention that incorporates storytelling, problem solving and goal setting, coping strategies, and diabetes education and skills training may be effective in this population. Therefore, we propose a pilot randomized study to test the feasibility and preliminary efficacy of a novel, community-informed, multicomponent intervention on mitigating stressors associated with multi- caregiving responsibilities to improve diabetes outcomes compared to diabetes enhanced usual care. The long-term goal of the project is to identify effective strategies for improving metabolic control and reducing diabetes complications and mortality rates in AAW with T2DM.

项目总结/文摘