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Schmittdiel JA, Cunningham SA, Adams SR, Nielsen J, Ali MK. Influence of a New Diabetes Diagnosis on the Health Behaviors of the Patient's Partner. Ann Fam Med 2018; 16:290-295. [PMID: 29987075 PMCID: PMC6037527 DOI: 10.1370/afm.2259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 02/23/2018] [Accepted: 03/21/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE When a person is given a diagnosis of diabetes, the changes in his or her health behaviors may influence the behaviors of his or her partner. The diabetes diagnosis may affect household members' perceptions of their own health risks, which could trigger behavioral change. The purpose of this study was to assess whether partners of persons with newly diagnosed diabetes changed their health behaviors compared with partners of persons without diabetes. METHODS The study population consisted of Kaiser Permanente Northern California health plan members from 2007 to 2011. This cohort study assessed differences in change of 8 health behaviors. The study compared coresiding partners of persons with newly diagnosed diabetes before and after a diabetes diagnosis with a 5 to 1 matched sample of coresiding partners of persons without diabetes. RESULTS A total of 180,910 couples were included in the analysis. After adjusting for baseline characteristics, partners of persons with newly diagnosed diabetes had significantly higher rates of participation in weight management-related health education classes (risk ratio [RR] = 1.50; 95% CI, 1.39-1.63); smoking cessation medication use (RR = 1.25; 95% CI, 1.05-1.50); glucose screening (RR = 1.07; 95% CI, 1.05-1.08); clinically meaningful weight loss (RR = 1.06; 95% CI, 1.02-1.11); lipid screening (RR = 1.05; 95% CI, 1.04-1.07); influenza vaccination (RR = 1.03; 95% CI, 1.02-1.04); and blood pressure screening (RR = 1.02; 95% CI, 1.02-1.03) compared with partners of persons without diabetes. CONCLUSIONS There were small but significant differences in health-related behavioral changes among partners of persons with newly diagnosed diabetes compared with partners of persons without diabetes, even when no intervention occurred. This finding suggests a diabetes diagnosis within a family may be a teachable moment to improve health behaviors at the household level.
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Affiliation(s)
- Julie A Schmittdiel
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | | | - Sara R Adams
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Jannie Nielsen
- Hubert Department of Global Health, Emory University, Atlanta, Georgia.,Global Health Section, Department of Public Health, University of Copenhagen, Denmark
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Happ MB, Mion LC, Duffy S. The challenge of multiple complex chronic conditions. Geriatr Nurs 2018; 39:244-246. [PMID: 29685208 DOI: 10.1016/j.gerinurse.2018.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mary Beth Happ
- The Ohio State University College of Nursing, Center of Excellence in Critical and Complex Care, Columbus, OH 43210, USA.
| | - Lorraine C Mion
- The Ohio State University College of Nursing, Center of Excellence in Critical and Complex Care, Columbus, OH 43210, USA
| | - Sonia Duffy
- The Ohio State University College of Nursing, Center of Excellence in Critical and Complex Care, Columbus, OH 43210, USA
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Sorkin DH, Rook KS, Campos B, Marquez B, Solares J, Mukamel DB, Marcus B, Kilgore D, Dow E, Ngo-Metzger Q, Nguyen DV, Biegler K. Rationale and study protocol for Unidas por la Vida (United for Life): A dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters. Contemp Clin Trials 2018; 69:10-20. [PMID: 29597006 PMCID: PMC5964027 DOI: 10.1016/j.cct.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lifetime risk of developing type 2 diabetes necessitates a culturally appropriate lifestyle intervention. PURPOSE Unidas por la Vida is a novel dyadic intervention that capitalizes on the centrality of family in Latino culture to mobilize an existing family dyad as a resource for health behavior change. The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. METHODS Participants (N = 460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic participation (mothers-daughters) in a lifestyle intervention; 2) individual participation (mothers alone; unrelated daughters alone) in a lifestyle intervention; and 3) mother-daughter dyads in a minimal intervention control group. RESULTS The primary outcome is weight loss. Secondary outcomes include physical activity, dietary intake, physiological measures (e.g. HbA1c), and body composition. Both the dyadic and individual interventions are expected to produce greater weight loss at 6, 12, and 18 months than those in minimal intervention control group, with women assigned to the dyadic intervention expected to lose more weight and to maintain the weight loss longer than women assigned to the individual intervention. CONCLUSION Because health risks are often shared by multiple members of at-risk families, culturally appropriate, dyadic interventions have the potential to increase the success of behavior change efforts and to extend their reach to multiple family members. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02741037.
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Affiliation(s)
- Dara H Sorkin
- Department of Medicine, University of California, Irvine, Irvine, CA, USA.
| | - Karen S Rook
- Department of Psychology and Social Behavior, University of California Irvine, Irvine, CA, USA
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California Irvine, Irvine, CA, USA
| | - Becky Marquez
- School of Public Health, Brown University, Providence, RI, USA
| | | | - Dana B Mukamel
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Bess Marcus
- School of Public Health, Brown University, Providence, RI, USA
| | - David Kilgore
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Emily Dow
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Quyen Ngo-Metzger
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; US Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Danh V Nguyen
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; Biostatistics, Epidemiology and Research Design, University of California Irvine, Irvine, CA, USA
| | - Kelly Biegler
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
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Evaluation of ¡Vivir Mi Vida! to improve health and wellness of rural-dwelling, late middle-aged Latino adults: results of a feasibility and pilot study of a lifestyle intervention. Prim Health Care Res Dev 2018; 19:448-463. [PMID: 29729677 DOI: 10.1017/s1463423617000901] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
AimThe aim of this study was to determine the feasibility and efficacy of a culturally tailored lifestyle intervention, ¡Vivir Mi Vida! (Live My Life!). This intervention was designed to improve the health and well-being of high risk late middle-aged Latino adults and to be implemented in a rural primary care system. BACKGROUND Rural-dwelling Latino adults experience higher rates of chronic disease compared with their urban counterparts, a disparity exacerbated by limited access to healthcare services. Very few lifestyle interventions exist that are both culturally sensitive and compatible for delivery within a non-metropolitan primary care context. METHODS Participants were 37 Latino, Spanish-speaking adults aged 50-64-years-old, recruited from a rural health clinic in the Antelope Valley of California. ¡Vivir Mi Vida! was delivered by a community health worker-occupational therapy team over a 16-week period. Subjective health, lifestyle factors, and cardiometabolic measures were collected pre- and post-intervention. Follow-up interviews and focus groups were held to collect information related to the subjective experiences of key stakeholders and participants.FindingsParticipants demonstrated improvements in systolic blood pressure, sodium and saturated fat intake, and numerous patient-centered outcomes ranging from increased well-being to reduced stress. Although participants were extremely satisfied with the program, stakeholders identified a number of implementation challenges. The findings suggest that a tailored lifestyle intervention led by community health workers and occupational therapists is feasible to implement in a primary care setting and can improve health outcomes in rural-dwelling, late middle-aged Latinos.
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Bhagavathula AS, Gebreyohannes EA, Abegaz TM, Abebe TB. Perceived Obstacles Faced by Diabetes Patients Attending University of Gondar Hospital, Northwest Ethiopia. Front Public Health 2018; 6:81. [PMID: 29637064 PMCID: PMC5881243 DOI: 10.3389/fpubh.2018.00081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/05/2018] [Indexed: 12/29/2022] Open
Abstract
Background Diabetes mellitus (DM) is a non-communicable, chronic, and progressive disease that can lead to serious complications and even to premature death. A closer understanding of the DM patients’ specific obstacles will provide a greater clarity of the factors influencing their disease-related quality of life and coping with daily life. The study aimed to evaluate the obstacles of DM patients attending ambulatory clinic of the University of Gondar Hospital (UOGH), Northwest Ethiopia. Methods A cross-sectional study was conducted from February to April 2017 at ambulatory clinic of the UOGH. A validated short version of the diabetic obstacle questionnaire was used. The internal reliability of the questionnaire was checked using Cronbach’s alpha and was found to be 92.5%. To determine any association between each of the nine sections of the questionnaire and age, sex, residence, educational status, and DM type, a binary logistic regression was performed. Results The mean age of respondents was 38.69 ± 15.39 years. Compared with patients with type 1 DM, patients with type 2 DM reported poorer relationships with medical professionals (adjusted odds ratio (AOR): 2.191, p-value = 0.027) and less support from families and friends (AOR: 1.913, p-value = 0.049). Patients coming from rural areas (AOR: 2.947, p = 0.002) and having no formal education (AOR: 2.078, p = 0.029) also received less support from families and friends. Conclusion DM patients in UOGH reported several obstacles related to patients’ relationship with health professionals, lack of support from their friends, lack of knowledge about DM, and lack of motivation to exercise. Effective efforts should be initiated to improve healthier environment to educate, care and preventive services for people with DM.
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Affiliation(s)
- Akshaya Srikanth Bhagavathula
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Eyob Alemayehu Gebreyohannes
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Tadesse Melaku Abegaz
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Tamrat Befekadu Abebe
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia.,Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Solna, Sweden
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Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Psychometric testing of the Family-Carer Diabetes Management Self-Efficacy Scale. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:214-223. [PMID: 29108139 DOI: 10.1111/hsc.12511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to develop and test the construct and content validity, internal consistency of the Family-Carer Diabetes Management Self-Efficacy Scale (F-DMSES). A sample of 70 Thai individuals who cared for those living with type 2 diabetes mellitus (T2DM) in a rural community in Thailand was included in the study. Data were collected by a questionnaire survey in January 2014. The F-DMSES was initially derived from the DMSES, with subsequent forward and backward translations from and to English and Thai languages. The psychometric properties (content, construct and internal consistency) of the Thai version were explored using the Content Validity Index approach, exploratory factor analysis and Cronbach's alpha test. The F-DMSES initially designed with 20 items was reduced to 14 items within four factors (general diet and blood glucose monitoring, medications and complications, diet in differing situations, and weight control and physical activities), and explained 72.2% of the total variance in overarching construct. Internal consistency was supported (α = 0.89). The F-DMSES was also able to measure change over time following an intervention, with an effect size of 0.9. The F-DMSES is a valid and reliable self-administered instrument that measures the diabetes management self-efficacy of family-carers of individuals with T2DM. This instrument can be used in practice and clinical trials to assess the impact of family-carers on the health outcomes of individuals with T2DM.
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Affiliation(s)
- Nutchanath Wichit
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
- Faculty of Nursing, Suratthani Rajabhat University, Suratthani, Thailand
| | - George Mnatzaganian
- College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Melbourne, VIC, Australia
| | - Mary Courtney
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Paula Schulz
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
- Ingham Institution of Applied Medical Research Liverpool, Sydney, NSW, Australia
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Vongmany J, Luckett T, Lam L, Phillips JL. Family behaviours that have an impact on the self-management activities of adults living with Type 2 diabetes: a systematic review and meta-synthesis. Diabet Med 2018; 35:184-194. [PMID: 29150863 DOI: 10.1111/dme.13547] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2017] [Indexed: 12/27/2022]
Abstract
AIMS To identify family behaviours that adults with Type 2 diabetes' perceive as having an impact on their diabetes self-management. BACKGROUND Research suggests that adults with Type 2 diabetes perceive that family members have an important impact on their self-management; however, it is unclear which family behaviours are perceived to influence self-management practices. METHODS This meta-synthesis identified and synthesized qualitative studies from the databases EMBASE, Medline and CINAHL published between the year 2000 and October 2016. Studies were eligible if they provided direct quotations from adults with Type 2 diabetes, describing the influence of families on their self-management. This meta-synthesis adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. RESULTS Of the 2606 studies screened, 40 were included. This meta-synthesis identified that adults with Type 2 diabetes perceive family behaviours to be either: 1) facilitators of diabetes self-management; 2) barriers to diabetes self-management; or 3) equivocal behaviours with the potential to both support and/or impede diabetes self-management. Seven sub-themes were identified within these themes, including: four facilitator sub-themes ('positive care partnerships'; 'family watchfulness'; 'families as extrinsic motivator' and 'independence from family'); two barrier sub-themes ('obstructive behaviours' and 'limited capacity for family support'); and one equivocal behaviours subtheme ('regular reminders and/or nagging'). CONCLUSION While most family behaviours are unambiguously perceived by adults with Type 2 diabetes to act as facilitators of or barriers to self-management, some behaviours were perceived as being neither clear facilitators nor barriers; these were termed 'equivocal behaviours'. If the concept of 'equivocal behaviours' is confirmed, it may be possible to encourage the adult living with Type 2 diabetes to reframe these behaviours so that they are perceived as enabling their diabetes self-management.
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Affiliation(s)
- J Vongmany
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - T Luckett
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - L Lam
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - J L Phillips
- Centre for Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Hemmati Maslakpak M, Razmara S, Niazkhani Z. Effects of Face-to-Face and Telephone-Based Family-Oriented Education on Self-Care Behavior and Patient Outcomes in Type 2 Diabetes: A Randomized Controlled Trial. J Diabetes Res 2017; 2017:8404328. [PMID: 29359166 PMCID: PMC5735644 DOI: 10.1155/2017/8404328] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/12/2017] [Accepted: 10/19/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Education of patients and their families is the cornerstone of effective diabetes care. The present study aimed to compare the effects of a face-to-face and telephone-based family-oriented educational program on self-care behavior and patient outcomes in type 2 diabetes patients. METHODS In the present randomized controlled trial, 90 type 2 diabetes patients were randomly divided into three groups of 30 participants: a face-to-face education group, a telephone-based education group, and a control group. The educational program lasted for 3 months. Outcomes evaluated included self-care, fasting blood sugar, hemoglobin A1c, cholesterol, and triglyceride. RESULTS The overall self-care scores in the intervention groups were significantly higher than that in the control group (P = 0.0001). In addition, lipid profiles significantly improved in the interventions compared to the control (P < 0.05). Comparing the two interventions showed better results for the face-to-face group regarding dietary adherence and physical activity, but the latter group had comparable results in blood glucose monitoring, foot care, and cholesterol level. CONCLUSIONS This study shows the beneficiary effects of a family-oriented education on self-care and patient outcomes. It also shows the potential value of low-cost telephone technology in delivering effective diabetes care.
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Affiliation(s)
- Masumeh Hemmati Maslakpak
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
- Department of Medical Surgical Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Somaieh Razmara
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
- Nursing Department, Nursing and Midwifery Faculty, Urmia University of Medical Sciences, Urmia, Iran
| | - Zahra Niazkhani
- Department of Health Information Technology, Urmia University of Medical Sciences, Urmia, Iran
- Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Mora N, Golden SH. Understanding Cultural Influences on Dietary Habits in Asian, Middle Eastern, and Latino Patients with Type 2 Diabetes: A Review of Current Literature and Future Directions. Curr Diab Rep 2017; 17:126. [PMID: 29063419 DOI: 10.1007/s11892-017-0952-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW This review focuses on evaluating and identifying gaps in the current literature regarding culturally specific dietary influences for patients with type 2 diabetes. As this topic has previously been examined in African American populations, we chose to focus on four other distinct populations (Hispanic, Middle Eastern, Western Pacific, South Asian). Given the rapid increase in global rates of type 2 diabetes and high rates of diabetes among certain ethnic groups, it is important to understand how culturally adapted strategies in diabetes management have been described in different regions and populations. RECENT FINDINGS The specific role of nutrition in controlling diabetes is tied to cultural habits and customs. Variation in cultural practices, including diet, create unique environments in which patients with diabetes must navigate. The role of family, particularly among Hispanics, is crucial to cultural adaptations of diabetes management. Incorporating alternative medicine, namely observed in Chinese and Indian populations, also guided diabetes care strategies. Language barriers, health literacy, and acculturation were all unique factors affecting cultural approaches to diabetes management in these four populations. Understanding such cultural determinants is crucial to addressing diabetes disparities and improving outcomes.
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Affiliation(s)
- Natalie Mora
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Sherita Hill Golden
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Suite 333, Baltimore, MD, 21287, USA.
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Pamungkas RA, Chamroonsawasdi K, Vatanasomboon P. A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients. Behav Sci (Basel) 2017; 7:E62. [PMID: 28914815 PMCID: PMC5618070 DOI: 10.3390/bs7030062] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 01/03/2023] Open
Abstract
The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were "type 2 diabetes," "self-management," "diabetes self-management education (DSME)," "family support," "social support," and "uncontrolled glycaemia." Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.
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Affiliation(s)
- Rian Adi Pamungkas
- Department of Family Health, Mahidol University, Bangkok 10400, Thailand.
- Department of Nursing, College of Health, Mega Rezky Makassar, Makassar 90245, Indonesia.
| | | | - Paranee Vatanasomboon
- Department of Health Education and Behavioral Science, Mahidol University, Bangkok 10400, Thailand.
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Sugiharto S, Stephenson M, Hsu YY, Fajriyah NN. Diabetes self-management education training for community health center nurses in Indonesia. ACTA ACUST UNITED AC 2017; 15:2390-2397. [DOI: 10.11124/jbisrir-2016-003329] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Kim Yeary KHC, Long CR, Bursac Z, McElfish PA. Design of a randomized, controlled, comparative-effectiveness trial testing a Family Model of Diabetes Self-Management Education (DSME) vs. Standard DSME for Marshallese in the United States. Contemp Clin Trials Commun 2017; 6:97-104. [PMID: 29740640 PMCID: PMC5936863 DOI: 10.1016/j.conctc.2017.03.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/24/2017] [Accepted: 03/28/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Type 2 diabetes (T2D) is a significant public health problem, with U.S. Pacific Islander communities-such as the Marshallese-bearing a disproportionate burden. Using a community-based participatory approach (CBPR) that engages the strong family-based social infrastructure characteristic of Marshallese communities is a promising way to manage T2D. OBJECTIVES Led by a collaborative community-academic partnership, the Family Model of Diabetes Self-Management Education (DSME) aimed to change diabetes management behaviors to improve glycemic control in Marshallese adults with T2D by engaging the entire family. DESIGN To test the Family Model of DSME, a randomized, controlled, comparative effectiveness trial with 240 primary participants was implemented. Half of the primary participants were randomly assigned to the Standard DSME and half were randomly assigned to the Family Model DSME. Both arms received ten hours of content comprised of 6-8 sessions delivered over a 6-8 week period. METHODS The Family Model DSME was a cultural adaptation of DSME, whereby the intervention focused on engaging family support for the primary participant with T2D. The Standard DSME was delivered to the primary participant in a community-based group format. Primary participants and participating family members were assessed at baseline and immediate post-intervention, and will also be assessed at 6 and 12 months. SUMMARY The Family Model of DSME aimed to improve glycemic control in Marshallese with T2D. The utilization of a CBPR approach that involves the local stakeholders and the engagement of the family-based social infrastructure of Marshallese communities increase potential for the intervention's success and sustainability.
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Affiliation(s)
- Karen Hye-cheon Kim Yeary
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, USA
| | - Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
| | - Zoran Bursac
- College of Medicine, University of Tennessee Health Science Center, 66 N. Pauline St., Memphis, TN 38163, USA
| | - Pearl Anna McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave., Fayetteville, AR 72703, USA
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Mesquita R, Nakken N, Janssen DJ, van den Bogaart EH, Delbressine JM, Essers JM, Meijer K, van Vliet M, de Vries GJ, Muris JW, Pitta F, Wouters EF, Spruit MA. Activity Levels and Exercise Motivation in Patients With COPD and Their Resident Loved Ones. Chest 2017; 151:1028-1038. [DOI: 10.1016/j.chest.2016.12.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/02/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022] Open
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Mcewen MM, Pasvogel A, Murdaugh CL. Family Self-Efficacy for Diabetes Management: Psychometric Testing. J Nurs Meas 2017; 24:E32-43. [PMID: 27103242 DOI: 10.1891/1061-3749.24.1.e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Type 2 diabetes mellitus (T2DM) self-management among Hispanic adults occurs in a family context. Self-efficacy (SE) affects T2DM self-management behaviors; however, no instruments are available to measure family diabetes self-efficacy. The study's purpose was to test the psychometric properties of the Family Self-Efficacy for Diabetes Scale (FSE). METHODS Family members (n = 113) of adults with T2DM participated. Psychometric analysis included internal consistency reliability and concurrent and construct validity. RESULTS Internal consistency reliability was .86. Items loaded on 2 factors, Family SE for Supporting Healthy Behaviors and Family SE for Supporting General Health, accounting for 71% of the variance. FSE correlated significantly with 3 diabetes-related instruments. CONCLUSIONS The FSE is a reliable and valid instrument. Further testing is needed in diverse populations and geographic areas.
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Wichit N, Mnatzaganian G, Courtney M, Schulz P, Johnson M. Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with Type 2 diabetes. Diabetes Res Clin Pract 2017; 123:37-48. [PMID: 27918976 DOI: 10.1016/j.diabres.2016.11.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
AIMS We evaluated a theoretically-derived family-oriented intervention aimed to improve self-efficacy, self-management, glycemic control and quality of life in individuals living with Type 2 diabetes in Thailand. METHODS In a single-blinded randomized controlled trial, 140 volunteer individuals with Type 2 diabetes, recruited from a diabetes clinic in rural Thailand, were randomly allocated to intervention and control arms. Those in the intervention arm received routine care plus a family-oriented program that included education classes, group discussions, a home visit, and a telephone follow-up while the control arm only received routine care. Improvement in outcomes over time (baseline, Week 3, and Week 13 following intervention) was evaluated using Generalized Estimating Equations multivariable analyses. RESULTS Except for age, no between-group significant differences were observed in all other baseline characteristics. Diabetes self-efficacy, self-management, and quality of life improved in the intervention arm but no improvement was observed in the controls. In the risk-adjusted multivariable models, compared to the controls, the intervention arm had significantly better self-efficacy, self-management, outcome expectations, and diabetes knowledge (p<0.001, in each). Participation in the intervention increased the diabetes self-management score by 14.3 points (β=14.3, (95% CI 10.7-17.9), p<0.001). Self-management was better in leaner patients and in females. No between-group differences were seen in quality of life or glycemic control, however, in the risk-adjusted multivariable models, higher self-management scores were associated with significantly decreased HbA1c levels (p<0.001) and improved patient quality of life (p<0.05) (irrespective of group membership). CONCLUSIONS Our family-oriented program improved patients' self-efficacy and self-management, which in turn could decrease HbA1c levels.
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Affiliation(s)
- Nutchanath Wichit
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia; Faculty of Nursing, Suratthani Rajabhat University, Suratthani, Thailand.
| | - George Mnatzaganian
- College of Science, Health and Engineering, La Trobe Rural Health School, La Trobe University, Victoria, Australia; Faculty of Health Sciences, Australian Catholic University, Sydney, Australia.
| | - Mary Courtney
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - Paula Schulz
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia.
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney, Australia; Ingham Institution of Applied Medical Research Liverpool, Sydney, Australia.
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Yeary KH, Aitaoto N, Sparks K, Ritok-Lakien M, Hudson JS, Goulden P, Bing W, Riklon S, Rubon-Chutaro J, Mcelfish PA. Cultural Adaptation of Diabetes Self-Management Education for Marshallese Residing in the United States: Lessons Learned in Curriculum Development. Prog Community Health Partnersh 2017; 11:253-261. [PMID: 29056617 PMCID: PMC5792062 DOI: 10.1353/cpr.2017.0030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Type 2 diabetes is a significant public health problem, with U.S. Pacific Islander communities bearing a disproportionate burden. The Marshallese are a Pacific Islander community that has significant inequities in diabetes, yet few evidence-based diabetes interventions have been developed to address this inequity. OBJECTIVES We used a community-based participatory research (CBPR) approach to adapt an evidence-based diabetes self-management education (DSME) intervention for the Marshallese. METHODS Our team used the Cultural Adaptation Process Model, in addition to an iterative process consisting of formative data and previous literature review, and engagement with community and academic experts. LESSONS LEARNED Specific cultural considerations were identified in adapting DSME components, including the dichotomous versus gradient conceptualization of ideas, the importance of engaging the entire family, the use of nature analogies, and the role of spirituality. CONCLUSIONS We identified key cultural considerations to incorporate into a diabetes self-management program for the Marshallese. The insights gained can inform others' work with Pacific Islanders.
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Cai C, Hu J. Effectiveness of a Family-based Diabetes Self-management Educational Intervention for Chinese Adults With Type 2 Diabetes in Wuhan, China. DIABETES EDUCATOR 2016; 42:697-711. [DOI: 10.1177/0145721716674325] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Purpose The purpose of the study was to examine the effects of a family-based self-management educational intervention on self-management in adults with type 2 diabetes mellitus (T2DM) in Wuhan, China. Methods A quasi-experimental design with repeated measures was employed. Chinese patients with T2DM (N = 57) and their family members were assigned to 2 groups. The intervention group (n1 = 29) received a tailored 7-session educational intervention and the control group (n2 = 28) received routine care in the community. Data were collected at pre- and postintervention and at the end of the 3-month follow-up. Descriptive analysis and repeated-measures analysis of variance were used to analyze the data. Results Participants with T2DM in the intervention group showed significance in greater reductions in A1C, body mass index, and waist circumference and significant improvements in diabetes knowledge, diabetes self-efficacy, self-care activities, and health-related quality of life compared with those in the control group. Family members in the intervention group had significant improvements in diabetes knowledge and health-related quality of life. Conclusion Study findings demonstrated that a family-based diabetes self-management intervention incorporating self-efficacy theory may help Chinese adults with T2DM in modifying their lifestyle and performing self-care activities to improve A1C management.
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Affiliation(s)
- Chun Cai
- Wuhan University, School of HOPE Nursing School, Wuchang district, Wuhan, China (Ms Cai)
- The Ohio State University, College of Nursing, Columbus, OH, USA (Dr Hu)
| | - Jie Hu
- Wuhan University, School of HOPE Nursing School, Wuchang district, Wuhan, China (Ms Cai)
- The Ohio State University, College of Nursing, Columbus, OH, USA (Dr Hu)
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Wakefield BJ, Vaughan-Sarrazin M. Home Telehealth and Caregiving Appraisal in Chronic Illness. Telemed J E Health 2016; 23:282-289. [PMID: 27631165 DOI: 10.1089/tmj.2016.0105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Remote health monitoring applications are being adopted to improve the health of chronically ill individuals. Little work has focused on the effects of these technologies on informal caregivers (CG) of patients with chronic illnesses. OBJECTIVES To examine differences in caregiving appraisal between CG of enrolled and nonenrolled Veterans in the home telehealth (HT) program. METHODS Cross-sectional survey methodology in 244 dyads (Veteran and CG) from 6 rural Midwestern Veterans Affairs Medical Centers. Survey variables were derived from the 2004 National Alliance for Caregiving survey, along with measures of caregiving strain, burden, and satisfaction. RESULTS We found no differences when comparing HT and non-HT CG. In multivariate analyses combining the two groups, CG characteristics associated with CG strain included younger age, providing help with activities of daily living and instrumental activities of daily living, use of coping skills, depressive symptoms, and less use of unpaid help (all p ≤ 0.001). Burden was associated with CG use of coping skills, caregiving confidence, and relationship quality with the Veteran (all p < 0.0001). CG satisfaction was associated with presence of social support (p < 0.0001). High CG strain was associated with Veteran hospitalization in the combined group (p = 0.03). Burden (p = 0.0002) was significantly associated with CG satisfaction. DISCUSSION Existing HT infrastructure provides an opportunity to incorporate training and support programs for CG of chronically ill patients. Such programs could improve CG confidence and use of positive coping skills, lower strain and burden, and potentially improve the health of both the care recipient and CG.
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Affiliation(s)
- Bonnie J Wakefield
- 1 Center for Comprehensive Access & Delivery Research and Evaluation , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.,2 Rural Health Resource Center-Central Region , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.,3 Sinclair School of Nursing, University of Missouri , Columbia, Missouri
| | - Mary Vaughan-Sarrazin
- 1 Center for Comprehensive Access & Delivery Research and Evaluation , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.,2 Rural Health Resource Center-Central Region , Iowa City Veteran's Affairs Healthcare System, Iowa City, Iowa.,4 Department of Internal Medicine, University of Iowa Roy and Lucille Carver College of Medicine , Iowa City, Iowa
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Soderlund PD. The Social Ecological Model and Physical Activity Interventions for Hispanic Women With Type 2 Diabetes: A Review. J Transcult Nurs 2016; 28:306-314. [DOI: 10.1177/1043659616649671] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hispanic women are less physically active and have higher rates of type 2 diabetes (DM2) when compared with other population groups. This review uses the social ecological model as a framework to identify the individual and social environmental factors associated with successful physical activity (PA) interventions for Hispanic women with DM2. Research questions include (a) Which social ecological levels have been applied to PA interventions? (b) Which individual and social environmental intervention strategies are associated with successful PA outcomes? Database searches using CINAHL, PubMed, and Scopus for the years 2000 to 2015 identified 10 studies; with 6 using quasi-experimental study designs and 4 using randomized controlled designs. Inclusion criteria were Hispanic/Latina women with DM2, ≥70% women, PA interventions, measures of PA, and quantitative designs. Future research should focus on a combination of intervention levels, and DM2 programs should place a greater emphasis on PA intervention strategies.
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Hu J, Amirehsani KA, Wallace DC, McCoy TP, Silva Z. A Family-Based, Culturally Tailored Diabetes Intervention for Hispanics and Their Family Members. DIABETES EDUCATOR 2016; 42:299-314. [PMID: 26957533 DOI: 10.1177/0145721716636961] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study was to test efficacy of a family-based, culturally tailored intervention for Hispanics with type 2 diabetes and their family members. METHODS Hispanic patients with type 2 diabetes and their family members recruited from community clinics and ethnic churches were assigned to groups (N = 186). The intervention group received an 8-week culturally tailored diabetes educational program delivered in Spanish while the attention control group received 8 weekly sessions on general health information and 2 sessions on diabetes after completion of the study. Data were collected at baseline, after intervention, and at 1- and 6-month follow-ups for both patients and families. Comparisons of change over time were performed using growth curve analyses after propensity score adjustment. RESULTS Intervention patients improved in diabetes knowledge and diabetes self-efficacy over time (but did not sustain at 6-month follow-up). A1C was lower at 1-month follow-up. Family members had improvements in diabetes knowledge and physical health-related quality of life. CONCLUSIONS Including families in the interventions may improve glycemic control, diabetes knowledge, self-efficacy, and physical health-related quality of life. However, strategies for sustaining improvements are needed.
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Affiliation(s)
- Jie Hu
- The Ohio State University, Columbus, Ohio (Dr Hu)
| | - Karen A Amirehsani
- The University of North Carolina at Greensboro North Carolina, Greensboro, North Carolina (Dr Amirehsani, Dr Wallace, Dr McCoy, Ms Silva)
| | - Debra C Wallace
- The University of North Carolina at Greensboro North Carolina, Greensboro, North Carolina (Dr Amirehsani, Dr Wallace, Dr McCoy, Ms Silva)
| | - Thomas P McCoy
- The University of North Carolina at Greensboro North Carolina, Greensboro, North Carolina (Dr Amirehsani, Dr Wallace, Dr McCoy, Ms Silva)
| | - Zulema Silva
- The University of North Carolina at Greensboro North Carolina, Greensboro, North Carolina (Dr Amirehsani, Dr Wallace, Dr McCoy, Ms Silva)
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McElfish PA, Bridges MD, Hudson JS, Purvis RS, Bursac Z, Kohler PO, Goulden PA. Family Model of Diabetes Education With a Pacific Islander Community. THE DIABETES EDUCATOR 2015; 41:706-15. [PMID: 26363041 PMCID: PMC5286927 DOI: 10.1177/0145721715606806] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of the study was to use a community-based participatory research approach to pilot-test a family model of diabetes education conducted in participants' homes with extended family members. METHODS The pilot test included 6 families (27 participants) who took part in a family model of diabetes self-management education (DSME) using an intervention-driven pre- and posttest design with the aim of improving glycemic control as measured by A1C. Questionnaires and additional biometric data were also collected. Researchers systematically documented elements of feasibility using participant observations and research field reports. RESULTS More than three-fourths (78%) of participants were retained in the study. Posttest results indicated a 5% reduction in A1C across all participants and a 7% reduction among those with type 2 diabetes. Feasibility of an in-home model with extended family members was documented, along with observations and recommendations for further DSME adaptations related to blood glucose monitoring, physical activity, nutrition, and medication adherence. CONCLUSIONS The information gained from this pilot helps to bridge the gap between knowledge of an evidence-based intervention and its actual implementation within a unique minority population with especially high rates of type 2 diabetes and significant health disparities. Building on the emerging literature of family models of DSME, this study shows that the family model delivered in the home had high acceptance and that the intervention was more accessible for this hard-to-reach population.
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Affiliation(s)
- Pearl Anna McElfish
- University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas (Dr McElfish, Dr Bridges, Prof Hudson, Dr Purvis, Dr Kohler)
| | - Melissa D Bridges
- University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas (Dr McElfish, Dr Bridges, Prof Hudson, Dr Purvis, Dr Kohler)
| | - Jonell S Hudson
- University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas (Dr McElfish, Dr Bridges, Prof Hudson, Dr Purvis, Dr Kohler)
| | - Rachel S Purvis
- University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas (Dr McElfish, Dr Bridges, Prof Hudson, Dr Purvis, Dr Kohler)
| | - Zoran Bursac
- Division of Biostatistics and the Center for Population Sciences, Department of Preventive Medicine for the College of Medicine at the University of Tennessee Health Science Center, Memphis, Tennessee (Dr Bursac)
| | - Peter O Kohler
- University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas (Dr McElfish, Dr Bridges, Prof Hudson, Dr Purvis, Dr Kohler)
| | - Peter A Goulden
- Department of Medicine, Division of Endocrinology and Metabolism at the University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr Goulden)
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Myers MF, Fernandes SL, Arduser L, Hopper JL, Koehly LM. Talking About Type 2 Diabetes: Family Communication From the Perspective of At-Risk Relatives. DIABETES EDUCATOR 2015; 41:716-28. [PMID: 26323720 DOI: 10.1177/0145721715604367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE The purpose of this study was to describe type 2 diabetes (T2DM) communication and risk reduction recommendations from the perspective of family members at risk for T2DM based on family history. METHODS Semistructured qualitative interviews were conducted with 33 individuals with a first-degree relative with T2DM. Participants were recruited from the community and a previous pharmacogenetics study. Deductive and inductive codes were applied to the transcripts. RESULTS Conversations with family members with and without T2DM focused on symptoms and disease management of the family member with T2DM. With at-risk relatives, conversations also focused on prevention. Lack of perceived relevance to family members without T2DM was a barrier to communication. Recommendations to facilitate communication included education of an at-risk family member to increase awareness of risk, followed by sharing of learned information with others. CONCLUSION Efforts are needed to increase awareness and improve communication about T2DM risk factors, familial risk, and risk reduction behaviors within families with a family history of T2DM. Family members with and without T2DM should be encouraged to communicate with their relatives about T2DM and the risk to family members. Identification of family members who can facilitate communication, education, and modeling of healthy behaviors may increase awareness and motivate at-risk individuals to engage in risk-reducing behaviors.
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Affiliation(s)
- Melanie F Myers
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH, USA (Dr Myers, Ms Fernandes, Ms Hopper)
- University of Cincinnati, College of Medicine, Cincinnati, OH, USA (Dr Myers, Ms Fernandes, Ms Hopper)
| | - Sara L Fernandes
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH, USA (Dr Myers, Ms Fernandes, Ms Hopper)
- University of Cincinnati, College of Medicine, Cincinnati, OH, USA (Dr Myers, Ms Fernandes, Ms Hopper)
- LabCorp Integrated Genetics, Monrovia, CA, USA (Ms Fernandes)
| | - Lora Arduser
- University of Cincinnati, College of Arts and Sciences, Cincinnati, OH, USA (Dr Arduser)
| | - Jennifer L Hopper
- Cincinnati Children's Hospital Medical Center, Department of Pediatrics, Cincinnati, OH, USA (Dr Myers, Ms Fernandes, Ms Hopper)
- University of Cincinnati, College of Medicine, Cincinnati, OH, USA (Dr Myers, Ms Fernandes, Ms Hopper)
| | - Laura M Koehly
- National Human Genome Research Institute, Social and Behavioral Research Branch, Bethesda, MD, USA (Dr Koehly)
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Baig AA, Benitez A, Quinn MT, Burnet DL. Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci 2015; 1353:89-112. [PMID: 26250784 DOI: 10.1111/nyas.12844] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Diabetes self-care is a critical aspect of disease management for adults with diabetes. Since family members can play a vital role in a patient's disease management, involving them in self-care interventions may positively influence patients' diabetes outcomes. We systematically reviewed family-based interventions for adults with diabetes published from 1994 to 2014 and assessed their impact on patients' diabetes outcomes and the extent of family involvement. We found 26 studies describing family-based diabetes interventions for adults. Interventions were conducted across a range of patient populations and settings. The degree of family involvement varied across studies. We found evidence for improvement in patients' self-efficacy, perceived social support, diabetes knowledge, and diabetes self-care across the studies. Owing to the heterogeneity of the study designs, types of interventions, reporting of outcomes, and family involvement, it is difficult to determine how family participation in diabetes interventions may affect patients' clinical outcomes. Future studies should clearly describe the role of family in the intervention, assess quality and extent of family participation, and compare patient outcomes with and without family involvement.
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Affiliation(s)
- Arshiya A Baig
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amanda Benitez
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Michael T Quinn
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Deborah L Burnet
- Department of Medicine, University of Chicago, Chicago, Illinois
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Hu J, Wallace DC, Amirehsani KA, McCoy TP, Coley SL, Wiseman KD, Silva ZA, Hussami CR. Improving Physical Activity in Hispanics with Diabetes and their Families. Public Health Nurs 2015; 32:625-33. [PMID: 25731967 DOI: 10.1111/phn.12190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study examined changes in physical activity among Hispanics with diabetes and their families who received an 8-week diabetes self-management intervention. DESIGN A quasi-experimental design was used to conduct a secondary analysis of physical activity data from two intervention studies that used the same protocols and measures. SAMPLE A total of 65 patients and 66 family members participated in the studies. MEASURES Physical activity was measured with the International Physical Activity Questionnaire (IPAQ) and pedometers. Self-report of physical activity was collected pre- and postintervention, and pedometer data for the 8 weeks of the intervention period. INTERVENTION The interventions consisted of 8 weeks of educational sessions. RESULTS IPAQ walking Metabolic Equivalent of Task (MET)-minutes per week significantly increased for patients (p < .001) and family members (p < .001) from pre- to postintervention as did moderate activity MET-minutes/week for family members (p = .004). Based on pedometer steps, the percentage of sedentary patients declined from 38% to 17% over the intervention record; differences in pedometer steps over time were not significant for patients (p = .803) or family members (p = .144). CONCLUSIONS Pedometers are a cost effective and user-friendly method of measuring physical activity. Pedometers can also serve as a motivator to help increase physical activity among Hispanics with diabetes and their family members.
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Affiliation(s)
- Jie Hu
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Debra C Wallace
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Karen A Amirehsani
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Thomas P McCoy
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Sheryl L Coley
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Kimberly D Wiseman
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Zulema A Silva
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Christina R Hussami
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, North Carolina
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Gefter L, Rosas LG, Rodriguez E, Morioka-Douglas N. Training At-Risk Youth to Become Diabetes Self-management Coaches for Family Members. DIABETES EDUCATOR 2014; 40:786-96. [DOI: 10.1177/0145721714549676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this study is to evaluate the impact of a school-based health program in which family medicine residents trained healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes. Methods A mixed methods study included 97 adolescents from 3 San Francisco Bay Area high schools serving primarily ethnic minority youth of low socioeconomic status. Physicians came to schools once a week for 8 weeks and trained 49 adolescents to become coaches. Student coaches and 48 nonparticipant students completed pre- and posttest intervention questionnaires, and 15 student coaches and 9 family members with diabetes gave in-depth interviews after participation. Linear regression was used to determine differences in knowledge and psychosocial assets on pre- and posttests between student coaches and nonparticipant students, and NVIVO was used to analyze interview transcripts. Results After controlling for initial score, sex, grade, and ethnicity, student coaches improved from pre- to posttest significantly compared to nonparticipants on knowledge, belonging, and worth scales. Student coaches reported high satisfaction with the program. Articulated program benefits included improvement in diet, increased physical activity, and improved relationship between student coach and family member. Conclusions Overall, this program can increase diabetes knowledge and psychosocial assets of at-risk youth, and it holds promise to promote positive health behaviors among at-risk youth and their families.
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Affiliation(s)
- Liana Gefter
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
| | - Lisa G. Rosas
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
| | - Eunice Rodriguez
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
| | - Nancy Morioka-Douglas
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
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Joo JY. Effectiveness of culturally tailored diabetes interventions for Asian immigrants to the United States: a systematic review. DIABETES EDUCATOR 2014; 40:605-15. [PMID: 24829268 DOI: 10.1177/0145721714534994] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this systematic review is to evaluate the effectiveness of tailoring community-based diabetes intervention to Asian immigrant cultures. METHODS The Cochrane processes and Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations guided this systematic review. PubMed, the Cumulative Index to Nursing and Allied Health Literature, Ovid, and PsycINFO were searched for analyses and syntheses of primary research published since 2000 that described interventions tailored for the cultures of Asian immigrants with diabetes. This search yielded a total of 9 articles published from 2005 to 2013. The Amsterdam-Maastricht Consensus List for Quality Assessment was used to assess the quality of the studies. RESULTS Retrieved studies' populations were foreign-born adults >50 years of age with type 2 diabetes. The review revealed that culturally tailored diabetes programs are effective at improving patients' objectively measured clinical outcomes, in particular A1C levels, and psychobehavioral outcomes. Patients were also highly satisfied with bilingual health care providers and bilingual educational programs. CONCLUSIONS There is strong evidence of the effectiveness of tailoring diabetes interventions to Asian immigrant populations' cultures. Further studies, including longitudinal studies and studies with rigorous research designs that subclassify Asian immigrants, are needed to encourage the implementation of culturally tailored diabetes intervention for this ethnic minority.
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Affiliation(s)
- Jee Young Joo
- College of Nursing, University of Missouri-St. Louis, St. Louis, Missouri (Dr Joo)
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