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Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, Maryniuk MD, Siminerio L, Vivian E. Diabetes Self-management Education and Support in Type 2 Diabetes. DIABETES EDUCATOR 2015; 41:417-30. [DOI: 10.1177/0145721715588904] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Margaret A. Powers
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Joan Bardsley
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Marjorie Cypress
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Paulina Duker
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Martha M. Funnell
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Amy Hess Fischl
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Melinda D. Maryniuk
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Linda Siminerio
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
| | - Eva Vivian
- International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers)
- MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley)
- ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress)
- LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker)
- University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell)
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Powers MA, Bardsley J, Cypress M, Duker P, Funnell MM, Fischl AH, Maryniuk MD, Siminerio L, Vivian E. Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. J Acad Nutr Diet 2015; 115:1323-34. [PMID: 26054423 DOI: 10.1016/j.jand.2015.05.012] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Indexed: 01/15/2023]
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Marcus BH, Dunsiger SI, Pekmezi D, Larsen BA, Marquez B, Bock BC, Gans KM, Morrow KM, Tilkemeier P. Twelve-month physical activity outcomes in Latinas in the Seamos Saludables trial. Am J Prev Med 2015; 48:179-182. [PMID: 25442225 PMCID: PMC5718346 DOI: 10.1016/j.amepre.2014.08.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/03/2014] [Accepted: 08/25/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Physical activity interventions designed for Latinas have shown short-term behavior change, but longer-term change and maintenance is rarely measured. PURPOSE To assess physical activity change at 12 months, following 6-month tapered completion of an RCT of a physical activity intervention for Latinas. METHODS Two hundred sixty-six underactive (<60 minutes/week physical activity) Latinas were randomized to an individually tailored, culturally and linguistically adapted physical activity intervention, or a wellness contact control. Participants received the materials through the mail for 6 months, then received booster doses at 8, 10, and 12 months. Minutes per week of moderate to vigorous physical activity were measured by the 7-Day Physical Activity Recall interview at baseline and 6 and 12 months. Data were collected at Brown University between 2009 and 2013, and analyses were conducted in 2013. RESULTS At 12 months, increases in moderate to vigorous physical activity were significantly greater in the intervention than in the wellness group (mean difference=52 minutes/week, SE=9.38, p<0.01), with both groups showing slight increases in moderate to vigorous physical activity from 6 to 12 months. Intervention participants were also more likely to meet national moderate to vigorous physical activity guidelines (OR=3.14, p=0.01). CONCLUSIONS The intervention was more effective than the wellness control at 12 months, and physical activity increases from baseline to 6 months were maintained, suggesting the intervention may lead to sustainable behavior change. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov NCT01583140.
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Affiliation(s)
- Bess H Marcus
- Department of Family and Preventive Medicine, University of California, San Diego, California.
| | - Shira I Dunsiger
- Centers for Behavioral and Preventive Medicine, Department of Psychiatry and Human Behavior, Miriam Hospital; Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Dori Pekmezi
- Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, Alabama
| | - Britta A Larsen
- Department of Family and Preventive Medicine, University of California, San Diego, California
| | - Becky Marquez
- Department of Family and Preventive Medicine, University of California, San Diego, California
| | - Beth C Bock
- Centers for Behavioral and Preventive Medicine, Department of Psychiatry and Human Behavior, Miriam Hospital; Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Kim M Gans
- Centers for Behavioral and Preventive Medicine, Department of Psychiatry and Human Behavior, Miriam Hospital; Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Kathleen M Morrow
- Centers for Behavioral and Preventive Medicine, Department of Psychiatry and Human Behavior, Miriam Hospital; Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Peter Tilkemeier
- Centers for Behavioral and Preventive Medicine, Department of Psychiatry and Human Behavior, Miriam Hospital; Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: a meta-analysis. Eur J Clin Nutr 2014; 69:1200-8. [DOI: 10.1038/ejcn.2014.243] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 08/23/2014] [Accepted: 09/27/2014] [Indexed: 11/09/2022]
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Abstract
BACKGROUND Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. OBJECTIVES To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014, and searched MEDLINE, EMBASE, PsycINFO, and CINAHL Plus in May 2014. SELECTION CRITERIA We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme (which we considered the control in this review). Studies were required to recruit smokers or recent quitters and have a follow-up of six months or more. Studies that did not meet the full inclusion criteria because they only assessed the acute effects of exercise on smoking behaviour, or because the outcome was smoking reduction, are summarised but not formally included. DATA COLLECTION AND ANALYSIS We extracted data on study characteristics and smoking outcomes. Because of differences between studies in the characteristics of the interventions used we summarized the results narratively, making no attempt at meta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We identified 20 trials with a total of 5,870 participants. The largest study was an internet trial with 2,318 participants, and eight trials had fewer than 30 people in each treatment arm. Studies varied in the timing and intensity of the smoking cessation and exercise programmes offered. Only one included study was judged to be at low risk of bias across all domains assessed. Four studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow-up and a benefit for exercise of borderline significance (p = 0.05) at the 12-month follow-up. Another study reported significantly higher abstinence rates at six month follow-up for a combined exercise and smoking cessation programme compared with brief smoking cessation advice. One study showed significantly higher abstinence rates for the exercise group versus a control group at the three-month follow-up but not at the end of treatment or 12-month follow-up. The other studies showed no significant effect for exercise on abstinence. AUTHORS' CONCLUSIONS Only two of the 20 trials offered evidence for exercise aiding smoking cessation in the long term. All the other trials were too small to reliably exclude an effect of intervention, or included an exercise intervention which may not have been sufficiently intense to achieve the desired level of exercise. Trials are needed with larger sample sizes, sufficiently intense interventions in terms of both exercise intensity and intensity of support being provided, equal contact control conditions, and measures of exercise adherence and change in physical activity in both exercise and comparison groups.
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Affiliation(s)
- Michael H Ussher
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, UK, SW17 0RE
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Ricci-Cabello I, Ruiz-Pérez I, Rojas-García A, Pastor G, Rodríguez-Barranco M, Gonçalves DC. Characteristics and effectiveness of diabetes self-management educational programs targeted to racial/ethnic minority groups: a systematic review, meta-analysis and meta-regression. BMC Endocr Disord 2014; 14:60. [PMID: 25037577 PMCID: PMC4107728 DOI: 10.1186/1472-6823-14-60] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/15/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is not clear to what extent educational programs aimed at promoting diabetes self-management in ethnic minority groups are effective. The aim of this work was to systematically review the effectiveness of educational programs to promote the self-management of racial/ethnic minority groups with type 2 diabetes, and to identify programs' characteristics associated with greater success. METHODS We undertook a systematic literature review. Specific searches were designed and implemented for Medline, EMBASE, CINAHL, ISI Web of Knowledge, Scirus, Current Contents and nine additional sources (from inception to October 2012). We included experimental and quasi-experimental studies assessing the impact of educational programs targeted to racial/ethnic minority groups with type 2 diabetes. We only included interventions conducted in countries members of the OECD. Two reviewers independently screened citations. Structured forms were used to extract information on intervention characteristics, effectiveness, and cost-effectiveness. When possible, we conducted random-effects meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. Two reviewers independently extracted all the information and critically appraised the studies. RESULTS We identified thirty-seven studies reporting on thirty-nine educational programs. Most of them were conducted in the US, with African American or Latino participants. Most programs obtained some benefits over standard care in improving diabetes knowledge, self-management behaviors and clinical outcomes. A meta-analysis of 20 randomized controlled trials (3,094 patients) indicated that the programs produced a reduction in glycated hemoglobin of -0.31% (95% CI -0.48% to -0.14%). Diabetes knowledge and self-management measures were too heterogeneous to pool. Meta-regressions showed larger reduction in glycated hemoglobin in individual and face to face delivered interventions, as well as in those involving peer educators, including cognitive reframing techniques, and a lower number of teaching methods. The long-term effects remain unknown and cost-effectiveness was rarely estimated. CONCLUSIONS Diabetes self-management educational programs targeted to racial/ethnic minority groups can produce a positive effect on diabetes knowledge and on self-management behavior, ultimately improving glycemic control. Future programs should take into account the key characteristics identified in this review.
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Affiliation(s)
- Ignacio Ricci-Cabello
- Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, 2nd floor, Walton Street, Jericho OX2 6NW, UK
- CIBER en Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Isabel Ruiz-Pérez
- CIBER en Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
- Andalusian School of Public Health, Granada, Spain
| | - Antonio Rojas-García
- CIBER en Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
- Andalusian School of Public Health, Granada, Spain
| | | | | | - Daniela C Gonçalves
- Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, 2nd floor, Walton Street, Jericho OX2 6NW, UK
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Quiñones AR, Richardson J, Freeman M, Fu R, O'Neil ME, Motu'apuaka M, Kansagara D. Educational group visits for the management of chronic health conditions: a systematic review. PATIENT EDUCATION AND COUNSELING 2014; 95:3-29. [PMID: 24468199 DOI: 10.1016/j.pec.2013.12.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 12/18/2013] [Accepted: 12/23/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Review the effectiveness of group visits (appointments of multiple patients) on quality of life, function, self-efficacy, utilization, and biophysical outcomes in randomized controlled trials of patients with chronic conditions. METHODS We searched MEDLINE(®), Cochrane, CINAHL, and PsycINFO to January 2013 for English-language trials of educational group visits led by non-prescribing facilitators (e.g., peer educators). RESULTS We report on 80 arthritis/falls (n=22), asthma/COPD (n=10), CHF/hypertension (n=12), diabetes (n=29), multiple conditions (n=4), and pain (n=4) studies. We found moderate evidence of improved short-term self-efficacy in patients with arthritis (10 studies) and diabetes (10 studies). We found no consistent evidence of improved quality of life; however a moderately strong body of evidence suggests peer-led community-based programs might improve quality of life and utilization in patients with multiple chronic conditions. Meta-analyses found short- (14 studies; mean change HbA1c=-0.27, CI=-0.44, 0.11) and long-term (10 studies; mean change HbA1c=-0.23, CI=-0.44, -0.02) glycemic improvement. CONCLUSIONS Group visits may improve self-efficacy and glycemic control. There was little consistent evidence of improved quality of life, functional status, or utilization. PRACTICE IMPLICATIONS Group visits represent a reasonable alternative for educating patients with chronic illness, though varied participation/retention suggests they should not be the sole alternative.
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Affiliation(s)
- Ana R Quiñones
- Portland VA Medical Center, Health Services Research & Development, Portland, USA; Oregon Health & Science University, Public Health & Preventive Medicine, Portland, USA.
| | - Jeannette Richardson
- Portland VA Medical Center, Health Services Research & Development, Portland, USA
| | - Michele Freeman
- Portland VA Medical Center, Health Services Research & Development, Portland, USA
| | - Rochelle Fu
- Portland VA Medical Center, Health Services Research & Development, Portland, USA; Oregon Health & Science University, Public Health & Preventive Medicine, Portland, USA
| | - Maya E O'Neil
- Portland VA Medical Center, Health Services Research & Development, Portland, USA; Oregon Health & Science University, Psychiatry, Portland, USA
| | | | - Devan Kansagara
- Portland VA Medical Center, Health Services Research & Development, Portland, USA; General Internal Medicine, Oregon Health & Science University, Portland, USA
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Maruthur NM, Gudzune K, Hutfless S, Fawole OA, Wilson RF, Lau BD, Anderson CAM, Bleich SN, Segal J. Avoiding weight gain in cardiometabolic disease: a systematic review. J Obes 2014; 2014:358919. [PMID: 25610639 PMCID: PMC4291140 DOI: 10.1155/2014/358919] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 06/03/2014] [Accepted: 10/16/2014] [Indexed: 11/28/2022] Open
Abstract
Patients with cardiometabolic disease are at higher risk for obesity-related adverse effects. Even without weight loss, weight maintenance may be beneficial. We performed a systematic review to identify the effect of nonweight loss-focused lifestyle interventions in adults with cardiometabolic disease. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify comparative studies of lifestyle interventions (self-management, diet, exercise, or their combination) without a weight loss focus in adults with or at risk for diabetes and cardiovascular disease. Weight, BMI, and waist circumference at ≥12 months were the primary outcomes. Of 24,870 citations, we included 12 trials (self-management, n = 2; diet, n = 2; exercise, n = 2; combination, n = 6) studying 4,206 participants. Self-management plus physical activity ± diet versus minimal/no intervention avoided meaningful weight (-0.65 to -1.3 kg) and BMI (-0.4 to -0.7 kg/m(2)) increases. Self-management and/or physical activity prevented meaningful waist circumference increases versus control (-2 to -4 cm). In patients with cardiometabolic disease, self-management plus exercise may prevent weight and BMI increases and self-management and/or exercise may prevent waist circumference increases versus minimal/no intervention. Future studies should confirm these findings and evaluate additional risk factors and clinical outcomes.
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Affiliation(s)
- Nisa M. Maruthur
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
- Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- *Nisa M. Maruthur:
| | - Kimberly Gudzune
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
| | - Susan Hutfless
- Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Oluwakemi A. Fawole
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Renee F. Wilson
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Brandyn D. Lau
- Division of Acute Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD 21287, USA
| | - Cheryl A. M. Anderson
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD 21287, USA
- Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA 92093, USA
| | - Sara N. Bleich
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
| | - Jodi Segal
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21287, USA
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Barrera M, Castro FG, Strycker LA, Toobert DJ. Cultural adaptations of behavioral health interventions: a progress report. J Consult Clin Psychol 2013; 81:196-205. [PMID: 22289132 PMCID: PMC3965302 DOI: 10.1037/a0027085] [Citation(s) in RCA: 384] [Impact Index Per Article: 34.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To reduce health disparities, behavioral health interventions must reach subcultural groups and demonstrate effectiveness in improving their health behaviors and outcomes. One approach to developing such health interventions is to culturally adapt original evidence-based interventions. The goals of the article are to (a) describe consensus on the stages involved in developing cultural adaptations, (b) identify common elements in cultural adaptations, (c) examine evidence on the effectiveness of culturally enhanced interventions for various health conditions, and (d) pose questions for future research. METHOD Influential literature from the past decade was examined to identify points of consensus. RESULTS There is agreement that cultural adaptation can be organized into 5 stages: information gathering, preliminary design, preliminary testing, refinement, and final trial. With few exceptions, reviews of several health conditions (e.g., AIDS, asthma, diabetes) concluded that culturally enhanced interventions are more effective in improving health outcomes than usual care or other control conditions. CONCLUSIONS Progress has been made in establishing methods for conducting cultural adaptations and providing evidence of their effectiveness. Future research should include evaluations of cultural adaptations developed in stages, tests to determine the effectiveness of cultural adaptations relative to the original versions, and studies that advance our understanding of cultural constructs' contributions to intervention engagement and efficacy.
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Affiliation(s)
- Manuel Barrera
- Department of Psychology, Arizona State University (Tempe, Arizona) and Oregon Research Institute (Eugene, Oregon)
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Glasgow RE, Askew S, Purcell P, Levine E, Warner ET, Stange KC, Colditz GA, Bennett GG. Use of RE-AIM to Address Health Inequities: Application in a low-income community health center based weight loss and hypertension self-management program. Transl Behav Med 2013; 3:200-210. [PMID: 23750180 DOI: 10.1007/s13142-013-0201-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND While health inequities are well documented, and there are helpful frameworks to understand health disparities, implementation frameworks are also needed to focus the design, evaluation and reporting on interventions targeting populations at increased risk. PURPOSE Describe how the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) can be used for these purposes and illustrate its application in the context of a randomized, pragmatic weight-loss and hypertension self-management intervention. METHODS RE-AIM was used to both plan and evaluate the Be Fit Be Well program for urban community health center patients. RESULTS The RE-AIM framework helped to focus attention on and produce high rates of adoption and reach. Implementation rates varied across components. Weight losses were statistically significant, but not clinically significant. They were robust across a variety of patient characteristics, and the program was relatively low cost. Individual weight losses and blood pressure reductions were maintained throughout the 24-month period, but the program was not sustained at any of the three settings. CONCLUSION Implementation frameworks such as RE-AIM can help design pragmatic interventions that focus on both the context for disparities reduction and the ultimate goal of public health impact.
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Affiliation(s)
- Russell E Glasgow
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
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Garber CE, Nigg CR. Perspectives on Intervening on Physical Inactivity and Diet. HEALTH EDUCATION & BEHAVIOR 2012; 39:123-6. [DOI: 10.1177/1090198112441938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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What patients want: relevant health information technology for diabetes self-management. HEALTH AND TECHNOLOGY 2012. [DOI: 10.1007/s12553-012-0022-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pagoto S. The current state of lifestyle intervention implementation research: where do we go next? Transl Behav Med 2011; 1:401-5. [PMID: 24073065 PMCID: PMC3717623 DOI: 10.1007/s13142-011-0071-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Sherry Pagoto
- University of Massachusetts Medical School, Worcester, MA USA
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