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Rahim E, Rahim FO, Anzaar HF, Lalwani P, Jain B, Desai A, Palakodeti S. Culturally Tailored Strategies to Enhance Type 2 Diabetes Care for South Asians in the United States. J Gen Intern Med 2024:10.1007/s11606-024-08902-8. [PMID: 38943015 DOI: 10.1007/s11606-024-08902-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/12/2024] [Indexed: 06/30/2024]
Abstract
South Asian immigrants in the United States face an elevated risk of developing type 2 diabetes (T2DM). This phenomenon has been linked to lifestyle factors and social determinants of health (SDOH) such as high-carbohydrate diet, limited physical activity, and stress from assimilation and other life challenges. Unfortunately, barriers stemming from language discordance, low health literacy, and certain cultural practices can hinder effective clinical management of T2DM among South Asian immigrants. In this perspective, we address these sociocultural barriers and propose culturally informed recommendations to improve healthcare delivery for South Asian groups and empower South Asian patients to self-manage T2DM. Our recommendations include (1) considerations and support for SDOH in South Asian communities, (2) culturally tailored healthcare delivery for South Asians, (3) mHealth technologies for T2DM education and self-management; and (4) enhanced epidemiological and South Asian-centric research.
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Affiliation(s)
| | | | | | | | - Bhav Jain
- Stanford University School of Medicine, Stanford, CA, USA
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Mazumder H, Islam KF, Rahman F, Gain EP, Saha N, Eva IS, Shimul MMH, Das J, Hossain MM. Prevalence of anemia in diabetes mellitus in South Asia: A systematic review and meta-analysis. PLoS One 2023; 18:e0285336. [PMID: 37163539 PMCID: PMC10171606 DOI: 10.1371/journal.pone.0285336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/20/2023] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE Anemia and Diabetes Mellitus (DM) are amongst major clinical and public health challenges in South Asia that influence the progression of chronic health problems in this population. Despite a growing body of research on these problems, there is a lack synthesized evidence on the burden of anemia among people with DM in this region. This meta-analytic review was conducted to estimate the prevalence of anemia among people with DM in South Asia. METHODS A systematic search of the literature was conducted in five primary databases and additional sources up to July 29, 2022, that reported the prevalence of anemia among DM patients in any of the eight South Asian countries. Observational studies that met pre-determined eligibility criteria according to the protocol registered in PROSPERO (CRD42022348433) were included in this meta-analysis. Random effect models were used to estimate pooled prevalence. RESULTS Of the 40 eligible studies, 38 underwent meta-analysis representing 14,194 participants with DM. The pooled prevalence of anemia was 45% (95% CI: 37.0-54.0, I2 = 99.28%, p = 0.00) among diabetic people in South Asia. In sub-group analysis, the pooled prevalence of anemia was higher in females (48%, 95% CI: 37.0-60.0, I2 = 98.86%, p = 0.00) compared to males (39%, 95% CI: 29.0-48.0, I2 = 98.18%, p = 0.00). Diabetic patients with older age (≥ 50 years) reported higher pooled estimates of anemia (48%, 95% CI: 38.0-58.0, I2 = 99.07%) than younger age group (< 50 years) (34%, 95% CI: 21.0-47.0, I2 = 98.83%). In addition, we found variation in pooled prevalence estimates of anemia considering the type of DM, such as type 1 reported 2% (95% CI: 0.00-4.00), type-2 reported 48% (95% CI: 40.0-56.0, I2 = 98.94%), and Gestational diabetes mellitus (GDM) reported 6% (95% CI: 3.00-12.0). CONCLUSION High pooled estimates of anemia among diabetic patients in South Asia, including publication bias, warrants further clinical and public health research following standard research methods to understand the more context-specific epidemiological insights and evidence.
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Affiliation(s)
| | - Kazi Faria Islam
- Research Initiative for Health Equity (RiHE), Khulna, Bangladesh
| | - Farzana Rahman
- Research Initiative for Health Equity (RiHE), Khulna, Bangladesh
| | | | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | | | | | - Jyoti Das
- North South University, Dhaka, Bangladesh
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Subhan FB, Fernando DN, Thorlakson J, Chan CB. Dietary Interventions for Type 2 Diabetes in South Asian Populations-A Systematic Review. Curr Nutr Rep 2023; 12:39-55. [PMID: 36443548 PMCID: PMC9707124 DOI: 10.1007/s13668-022-00446-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE South Asians face a high burden of type 2 diabetes (T2D). We systematically summarized current research on the efficacy, cultural relevance, and research gaps of nutrition interventions that could be used for treatment in this population. FINDINGS We identified 18 articles published since 2010. Dietary pattern interventions have focused on low-glycemic index (GI) solutions and consistently reported improvement in glycemic management. Trials of nutrition education and counselling had diverse approaches, with those utilizing more intensive interventions generally eliciting better glycemic outcomes. Many studies developed interventions with cultural relevance by including traditional foods, providing materials in the local language, and acknowledging important food-related customs. These adaptations were seen in South Asian countries as well as Western countries hosting immigrants. Data from South Asian countries support low-GI and intensive counselling approaches for the treatment of T2D. Given the high prevalence of T2D in these populous countries, approaches that can reach large numbers of people are needed. In Western countries, more emphasis on providing culturally relevant nutrition therapy is needed.
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Affiliation(s)
- Fatheema B. Subhan
- Department of Nutrition and Food Science, California Polytechnic State University at Pomona, Pomona, CA 91768 USA
| | - Dineli N. Fernando
- Department of Cell Biology, University of Alberta, Edmonton, AB T6G 2H7 Canada
| | | | - Catherine B. Chan
- Department of Agricultural, Food and Nutritional Science & Department of Physiology, 4-126A Li Ka Shing Centre for Health Innovation Research, University of Alberta, Edmonton, AB T6G 2E1 Canada
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Paudel G, Vandelanotte C, Dahal PK, Biswas T, Yadav UN, Sugishita T, Rawal L. Self-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis. J Glob Health 2022; 12:04056. [PMID: 35916498 PMCID: PMC9346342 DOI: 10.7189/jogh.12.04056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The burden of Type 2 Diabetes Mellitus (T2DM) in South Asian countries is increasing rapidly. Self-care behaviour plays a vital role in managing T2DM and preventing complications. Research on self-care behaviours among people with T2DM has been widely conducted in South Asian countries, but there are no systematic reviews that assess self-care behaviour among people with T2DM in South Asia. This study systematically assessed the studies reporting self-care behaviours among people with T2DM in South-Asia. Methods Adhering to the PRISMA guidelines, we searched six bibliographic databases (Scopus, PubMed, CINAHL, Embase, Web of Science, and PsychInfo) to identify the relevant articles published between January 2000 through March 2022. Eligibility criteria included all observational and cross-sectional studies reporting on the prevalence of self-care behaviours (ie, diet, physical activity, medication adherence, blood glucose monitoring, and foot care) conducted in South Asian countries among people with T2DM. Results The database search returned 1567 articles. After deduplication (n = 758) and review of full-text articles (n = 192), 92 studies met inclusion criteria and were included. Forward and backward reference checks were performed on included studies, which resulted in an additional 18 articles. The pooled prevalence of adherence to blood glucose monitoring was 65% (95% CI = 49-80); 64% for medication adherence (95% CI = 53-74); 53% for physical activity (95% CI = 39-66); 48% for diet (95% CI = 38-58); 42% for foot care (95% CI = 30-54). About a quarter of people with T2DM consumed alcohol (25.2%, IQR = 13.8%-38.1%) and were using tobacco products (18.6%, IQR = 10.6%-23.8%). Conclusions Our findings suggest that the prevalence of self-care behaviours among people with T2DM in South Asia is low. This shows an urgent need to thoroughly investigate the barriers to the practising of self-care and design and implement interventions to improve diabetes self-care behaviour among people with T2DM in South Asia.
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Affiliation(s)
- Grish Paudel
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Padam K Dahal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Tuhin Biswas
- The Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Uday N Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Tomohiko Sugishita
- Section of Global Health, Division of Public Health, Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia.,Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Sydney Australia
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Hu XY, Chang Y, Xu ZZ, Wang Y, Dai MM, Yu KK, Sun CB, Dong MX, Zhang JX, Xu N, Liu WS, Chen ZA. Rubusoside Reduces Blood Glucose and Inhibits Oxidative Stress by Activating the AMPK Signaling Pathway in Type 2 Diabetes Mellitus Mice. Nat Prod Commun 2022. [DOI: 10.1177/1934578x211069230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The current study aimed at investigating the therapeutic effects of rubusoside on type 2 diabetes mellitus (T2DM) mice models as an alternative hypoglycemic candidate drug. T2DM mice models were established with a combination of streptozotocin (STZ) intraperitoneal injection and high-fat diet. After 10 weeks of rubusoside intragastric administration (100, 200 mg/kg/day) to the mice, the body weight, fasting blood glucose, glucose tolerance, and blood lipids were measured. The liver protein expression levels of p-AMPK, GLUT2, GLUT4 and total antioxidant capacity were also investigated. After 10 weeks of rubusoside administration, the levels of blood glucose and lipids were decreased in T2DM mice. Compared with the model group, rubusoside administration significantly decreased the liver mass-to-body weight ratio, upregulated p-AMPK and GLUT4, and downregulated GLUT2 expression levels in the liver. Activities of superoxide dismutase (SOD), catalase (CAT), and gluathione peroxidase (GSH-Px) were increased, and the concentration of malondialdehyde (MDA) was decreased to reduce oxidative stress in the liver. Liver hematoxylin and eosin (H&E) pathological analysis also showed that rubusoside had a protective effect on T2DM mice liver. These results demonstrate that rubusoside could be used as an anti-diabetic candidate drug, and that its hypoglycemic mechanism might be related to the activation of adenosine 5′-monophosphate (AMP)-activated protein kinase (AMPK) to modulate the expression of GLUT2 and GLUT4. Finally, rubusoside could also increase total antioxidant capacity to protect the liver from oxidative stress.
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Affiliation(s)
- Xi-yu Hu
- College of Medical, Yanbian University, Yanji, PR China
| | | | - Zheng-zhe Xu
- Affiliated Hospital of Yanbian University, Yanji Jilin 133002, China
| | - Yan Wang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Min-min Dai
- College of Medical, Yanbian University, Yanji, PR China
| | - Kai-kai Yu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Cheng-biao Sun
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Ming-xin Dong
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Jian-xu Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Na Xu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
- Jilin Medical College, Jilin, China
| | - Wen-sen Liu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Science, Changchun, 130122, China
| | - Zheng-ai Chen
- College of Medical, Yanbian University, Yanji, PR China
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Participant-directed intervention tailoring is associated with improvements in glycemic control for South Asian adults with type 2 diabetes. Can J Diabetes 2021; 46:287-293. [DOI: 10.1016/j.jcjd.2021.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/26/2021] [Accepted: 11/06/2021] [Indexed: 11/18/2022]
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Koipuram A, Carroll S, Punthakee Z, Sherifali D. Diabetes knowledge, risk perception, and quality of life among South Asian caregivers in young adulthood. BMJ Open Diabetes Res Care 2020; 8:8/2/e001268. [PMID: 33168524 PMCID: PMC7654120 DOI: 10.1136/bmjdrc-2020-001268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/10/2020] [Accepted: 10/18/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Persons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers. RESEARCH DESIGN AND METHODS To investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics. RESULTS There was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver's physical health (p=0.002). CONCLUSION Findings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.
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Affiliation(s)
- Angela Koipuram
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sandra Carroll
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Zubin Punthakee
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Is YouTube Useful as a Source of Health Information for Adults With Type 2 Diabetes? A South Asian Perspective. Can J Diabetes 2017; 42:395-403.e4. [PMID: 29282200 DOI: 10.1016/j.jcjd.2017.10.056] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/10/2017] [Accepted: 10/18/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate the content, quality and popularity of information about type 2 diabetes available on YouTube. METHODS We searched YouTube with the terms Diabetes, Diabetes type 2, Diabetes South Asians, Diabetes Punjabi and Diabetes Hindi to identify videos concerning type 2 diabetes. A team of health-care providers independently classified the first 20 videos from each search as useful, misleading, or personal experience, rated them on a 5-point global quality scale (GQS) and categorized their content on a 26-point scale in duplicate. Useful videos were rated for reliability by using a 5-point modified DISCERN scale. Higher scores represent better quality, reliability and comprehensiveness. RESULTS Of 100 videos, 71 met the inclusion criteria; 45 (63.4%) were rated as useful (median GQS, 3; interquartile range [IQR], 2 to 4); and 23 (32.4%) were deemed misleading (median GQS, 1; IQR, 1 to 2). Median reliability and content scores for useful videos were 3 (IQR, 2 to 3) and 5 (IQR, 3 to 10), respectively, and 6 videos met ≥ 4 of 5 reliability criteria. Overall, misleading videos were more popular than useful videos (median, 233 views/day; IQR, 26 to 523; vs. 8.3 views/day; IQR, 0.4 to 134.6; p<0.01). Culturally tailored videos were just as likely to be misleading and had similar GQS scores in comparison to nonculturally tailored videos (32.1% vs. 32.6% and 3 vs. 3, respectively). CONCLUSIONS The quality of identified videos concerning type 2 diabetes was variable, and misleading videos were popular. Further creation and curation of high-quality video resources is required.
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Uppal G, Sibbald SL, Melling J. Exploring diabetes management amongst immigrant Sikhs in the Greater Toronto Area: a qualitative study. ETHNICITY & HEALTH 2016; 21:551-563. [PMID: 26947087 DOI: 10.1080/13557858.2016.1143088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This study describes the ethnocultural influences associated with managing diabetes (Type 2) in a small sample of older Sikh immigrants in Toronto, Canada. The South Asian community, which includes Sikhs, is the fastest growing immigrant population, the second largest visible minority in Canada, and is five times more likely to have diabetes than their Canadian counterparts. The relationship between culture, immigration, and management of diabetes has been recognized, but research of how these areas intersect in the Sikh community is sparse. DESIGN Data were collected using qualitative semi-structured interviews, and participants were recruited via purposive and snowball sampling techniques. Data were analysed using constant comparative methods. RESULTS The complexities of diabetes management are organized in this study as the (1) external (2) internal and (3) actualized experiences participants faced navigating cultural dynamics, understanding their diagnosis, and interacting with health resources. CONCLUSION An individual's diabetes diagnosis and treatment plan interacts with layers beyond the health system which must be understood in order to provide health care that is truly an empowering resource.
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Affiliation(s)
- Gina Uppal
- a School of Health Studies, Faculty of Health Sciences , Western University , London , ON , Canada
| | - Shannon L Sibbald
- a School of Health Studies, Faculty of Health Sciences , Western University , London , ON , Canada
- b Schulich Interfaculty Program in Public Health and Department of Family Medicine , Schulich School of Medicine and Dentistry, Western University , London , ON , Canada
| | - James Melling
- c School of Kinesiology, Faculty of Health Sciences , Western University , London , ON , Canada
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van Draanen J, Shafique A, Farissi A, Wickramanayake D, Kuttaiya S, Oza S, Stephens N. How to offer culturally relevant type 2 diabetes screening: lessons learned from the South asian diabetes prevention program. Can J Diabetes 2014; 38:329-33. [PMID: 24797496 DOI: 10.1016/j.jcjd.2013.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 11/08/2013] [Accepted: 11/19/2013] [Indexed: 10/25/2022]
Abstract
The literature on diabetes mellitus in the South Asian population clearly states the high-risk status of this group, yet there is a lack of effective models of culturally relevant, community-based screening and education programs for such a group. The South Asian Diabetes Prevention Program (SADPP) was developed to enhance equitable access to diabetes prevention resources for the South Asian communities in Toronto by offering language-specific and culturally relevant services. The SADPP model works through 3 participant education sessions plus an additional attachment and enrolment component. The screening tool that SADPP uses to provide participants with their individual risk score at the first education session is derived from the multiculturally validated Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which has been modified to reflect the distinctive characteristics of the South Asian population. After analyzing the risk scores, 32% of participants were at increased risk, 40% were at high risk, 21% were at very high risk and only 7% were found to be at low risk of diabetes development. Evaluations of the program conducted in 2010 and 2013 revealed that the program is achieving its objectives and that participants increase their knowledge and self-efficacy related to diabetes prevention after program participation. Participants reported that the presentation from the nurse and dietitian, the question-and-answer time, the healthy eating demonstration, the multiple languages of delivery and the convenient location were especially beneficial. Those working in the field are encouraged to adapt this model and to contribute to the development of culturally relevant, community-driven diabetes prevention programs.
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Affiliation(s)
| | | | - Aziz Farissi
- Flemingdon Health Centre, Toronto, Ontario, Canada
| | | | | | - Shobha Oza
- Flemingdon Health Centre, Toronto, Ontario, Canada
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Venkatesh S, Weatherspoon LJ, Kaplowitz SA, Song WO. Acculturation and glycemic control of Asian Indian adults with type 2 diabetes. J Community Health 2013; 38:78-85. [PMID: 22744164 DOI: 10.1007/s10900-012-9584-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The prevalence of type 2 diabetes is disproportionately high among Asian Indians (AI), one of the fastest growing immigrant groups in the United States (US). Poorly controlled diabetes associated with inadequate self-management increases complications and thus medical costs. Acculturation may be an important determinant of diabetes self-management and hence control. This study examined the association between the degree of acculturation and glycemic control as measured by Hemoglobin A1c in AI adults with type 2 diabetes. A mixed method (quantitative and qualitative) study was conducted among 30 AI adults with type 2 diabetes. Acculturation assessment using the Suinn-Lew Asian Self-identity Instrument was followed by socio-demographic questions, self-reported anthropometric measures, and open ended diabetes self-care questions. A two-step multiple regression analysis and content analysis of verbatim interview transcriptions were conducted. Interactions of acculturation with body mass index (interaction b = 1.11; p = 0.01), annual household income (interaction b = 7.19; p = .01), and diabetes duration (interaction b = .30; p = .02) significantly predicted higher HbA1c levels (R(2) change = .368; F change = 4.21; p = .02). From the qualitative interviews, the following were regarded as US specific facilitators for glycemic control: excellent health care system and facilities, availability of healthy food choices and self-monitoring devices, medical insurance benefits, good quality medications, and improved health awareness. Cultural orientation might be important for patient tailored interventions targeting AI with type 2 diabetes. Therefore, interventions targeted at Asian Indians with diabetes should include culture specific adaptations to nutrition education and support.
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Affiliation(s)
- Sumathi Venkatesh
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824-1224, USA.
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Tang TS, Sohal PS, Garg AK. Evaluating a diabetes self-management support peer leader training programme for the English- and Punjabi-speaking South-Asian community in Vancouver. Diabet Med 2013; 30:746-52. [PMID: 23506520 DOI: 10.1111/dme.12179] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/13/2013] [Indexed: 11/26/2022]
Abstract
AIMS The purpose of this single-cohort study was to implement and evaluate a programme that trains peers to deliver a diabetes self-management support programme for South-Asian adults with Type 2 diabetes and to assess the perceived efficacy of and satisfaction with this programme. METHODS We recruited eight South-Asian adults who completed a 20-h peer-leader training programme conducted over five sessions (4 h per session). The programme used multiple instructional methods (quizzes, group brainstorming, skill building, group sharing, role-play and facilitation simulation) and provided communication, facilitation, and behaviour change skills training. To graduate, participants were required to achieve the pre-established competency criteria in four training domains: active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy. Participants were given three attempts to pass each competency domain. RESULTS On the first attempt six (75%), eight (100%), five (63%) and five (63%) participants passed active listening, empowerment-based facilitation, five-step behavioural goal-setting, and self-efficacy, respectively. Those participants who did not pass a competency domain on the first attempt were successful in passing on the second attempt. As a result, all eight participants graduated from the training programme and became peer leaders. Satisfaction ratings for programme length, balance between content and skills development, and preparation for leading support activities were uniformly high. Ratings for the instructional methods ranged between effective and very effective. CONCLUSION Findings suggest it is feasible to train and graduate peer leaders with the necessary skills to facilitate a diabetes self-management support intervention.
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Affiliation(s)
- T S Tang
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Ramachandran A, Snehalatha C, Samith Shetty A, Nanditha A. Primary prevention of Type 2 diabetes in South Asians--challenges and the way forward. Diabet Med 2013; 30:26-34. [PMID: 22827704 DOI: 10.1111/j.1464-5491.2012.03753.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Preventing diabetes is of enormous value, particularly for the South Asian countries, which have a huge healthcare burden from the onslaught of the disease. Type 2 diabetes has been proved to be preventable using lifestyle changes, even in South Asians despite their heightened risk profile. Strategies to improve awareness about diabetes and translation of preventive measures by innovative, culturally specific programmes have to be implemented at national levels. Integrated involvement of the government, community, media, healthcare and education services, and financial support from national and international organizations, are required. South Asian countries have initiated national programmes for diabetes prevention and management. It is also encouraging to note that joint ventures between developed countries such as the USA, UK and other European countries and centres of excellence in South Asia have been initiated to develop large-scale, community-oriented, pragmatic intervention strategies.
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Affiliation(s)
- A Ramachandran
- India Diabetes Research Foundation and Dr A Ramachandran's Diabetes Hospitals, Chennai, India
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Management of Hypertension in People with Diabetes Mellitus: Translating the 2012 Canadian Hypertension Education Program Recommendations into Practice. Can J Diabetes 2012. [DOI: 10.1016/j.jcjd.2012.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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