Diabetes Care for Korean Americans

描述(申请人提供)：这项研究的主要目标是为患有2型糖尿病(DM)的韩裔美国移民(KAI)开发一种创新的血糖控制干预计划，该计划具有文化敏感性，建立在有效的行为理论和原则基础上，并加强对血糖水平的控制，提高与健康相关的生活质量。具体地说，我们专注于DM控制的自助方面，通过赋予患者更好的DM知识和DM饮食知识，促进与他们的医疗保健提供者更好的沟通，并提高他们解决问题的一般技能。我们建议进行一项试点项目，以设计和评估专门为KAI 2型糖尿病患者设计的自助血糖控制干预计划的疗效。这一自助干预将包括三个同时实施的部分：(1)注重培养管理糖尿病自助技能的结构化心理行为教育干预；(2)使用电话传输系统(HGMT)监测家庭血糖；(3)与双语护士病例经理互动，以促进KAI与2型DM及其护理人员之间的有效沟通。我们的具体目标是：(1)细化干预方案，明确对2型糖尿病患者进行自助干预的过程和内容；(2)在大巴尔的摩-华盛顿地区招募80名2型糖尿病患者(年龄=30岁)，随机分配40名KAI参加自助干预计划，该计划将包括3个组成部分：社区环境中提供的心理行为DM教育计划，使用HGMT设备进行30周的家庭血糖监测，以及与双语护士病例经理的频繁交流；以及(3)与常规护理相比，衡量自助干预计划对血糖控制和心理行为结果的影响，包括自我效能、解决问题的技能和对治疗建议的遵守。在干预前(0周)、干预后18周和30周测量近端(血糖控制、使能技能和自助的自我护理行为)和远端(血糖控制和健康相关生活质量)结果变量。从这项试点调查中获得的见解应该有助于我们开发有效的、对文化敏感的自助方案，以便在全美大都市地区更广泛地应用于患有2型糖尿病的KAI患者。

DESCRIPTION (provided by applicant): The primary objective of this study is to develop an innovative glucose control intervention program for Korean American immigrants (KAI) with type 2 diabetes mellitus (DM) that is culturally sensitive, built on valid behavioral theory and principles, and enhances the control of glucose level and promotes health related quality of life. Specifically, we focus on the self-help aspect of DM control by empowering patients with better knowledge about DM and DM diet, facilitating better communication with their health care providers, and enhancing their general problem-solving skills. We propose to undertake a pilot project to design and evaluate the efficacy of self-help glucose control intervention program specially designed for KAI with type 2 DM. This self-help intervention will have 3 concurrently administered components: (1) a structured psycho-behavioral education intervention that focuses on fostering self-help skills in managing DM; (2) home glucose monitoring with a telephone transmission system (HGMT); and (3) interaction with a bilingual nurse case manager who will facilitate effective communication between KAI with type 2 DM and their care providers. Our specific aims are to: (1) refine an intervention protocol that specifies the process and content of the self-help intervention for KAI with type 2 DM; (2) enroll 80 KAI (>= 30 years of age) with type 2 DM in greater Baltimore-Washington area and randomly assign 40 KAI to the self-help intervention program, which will consist of 3 components: a psycho-behavioral DM education program delivered in community settings, home glucose monitoring with an HGMT device for 30 weeks, and frequent communication with a bilingual nurse case manager; and (3) measure the effect of the self-help intervention program on glucose control and psycho-behavioral outcomes, including self-efficacy, problem-solving skills, and adherence to treatment recommendations, in comparison to usual care. The proximal (self-care behaviors of glucose control, enabling skills, and self-help) and distal (glucose control and health-related quality of life) outcome variables will be measured before the intervention (week 0) and at 18 and 30 weeks after the start of the intervention. Insights gained in this pilot investigation should help us to develop effective, culturally sensitive self-help protocols for wider application to KAI with type 2 DM in metropolitan areas throughout the U.S.