Diabetes Care for Korean Americans

描述（由申请人提供）：本研究的主要目的是为美籍韩裔移民（KAI）的2型糖尿病（DM）开发一种创新的血糖控制干预方案，该方案建立在有效的行为理论和原则的基础上，具有文化敏感性，并能增强对血糖水平的控制，促进与健康相关的生活质量。具体来说，我们关注糖尿病控制的自助方面，通过使患者更好地了解糖尿病和糖尿病饮食，促进与医疗保健提供者的更好沟通，提高他们的一般解决问题的能力。我们建议开展一个试点项目，设计和评估专门为患有2型糖尿病的KAI患者设计的自助血糖控制干预计划的效果。这种自助干预将包括3个并行管理的组成部分：(1)结构化的心理行为教育干预，重点是培养管理糖尿病的自助技能；(2)家庭血糖监测与电话传输系统（HGMT）；(3)与双语护士病例管理员进行互动，这将促进KAI与2型糖尿病及其护理提供者之间的有效沟通。我们的具体目标是：(1)完善干预方案，明确2型糖尿病KAI自助干预的过程和内容；(2)在巴尔的摩-华盛顿地区招募80名患有2型糖尿病的KAI （b> = 30岁），并随机将40名KAI分配到自助干预计划中，该计划将包括3个组成部分：在社区环境中提供的心理-行为糖尿病教育计划，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管理人员的频繁沟通；(3)测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，解决问题的能力，以及对治疗建议的依从性，与常规护理相比。将在干预前（第0周）和干预开始后18周和30周测量近端（血糖控制的自我护理行为、使能技能和自助）和远端（血糖控制和健康相关生活质量）结果变量。在这项试点调查中获得的见解应该有助于我们制定有效的、文化敏感的自助方案，以便在美国大都市地区更广泛地应用于2型糖尿病的KAI

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.