50-LB: Impact of Diabetes Self-Management Education (DSME) on A1C in High-Risk and Low-Income Chinese Immigrant Populations Residing in Urban Communities

BackgroundDiabetes self-management education (DSME) programs utilize a multidisciplinary, skills-based approach allowing participants to make self-management choices and follow a comprehensive plan of care, improving their glycemic control.ObjectiveThe purpose of this quality improvement project was to evaluate the effectiveness of DSME on the reduction of hemoglobin A1c (HgbA1c) and body mass index (BMI) in overweight/obese community health center patients.MethodsThe free program met 2 hours weekly for 6 consecutive weeks. A retrospective chart review was conducted to compare baseline to post-session HgbA1c and BMI 12 weeks after completion of the program. Pre- and post-session surveys were also conducted to assess improved diabetes knowledge and confidence.ResultsMean HgbA1c decreased by 1.6% (p = .003) 12 weeks after completion of the program; however, BMI remained unchanged (p = .582). Diabetes knowledge and confidence also improved significantly following DSME (p = .000 and p = .001, respectively).ConclusionsThe study demonstrated that a reduction in HgbA1c levels and an increase in diabetes knowledge and confidence can occur in low income, community health center patients following participation in DSME.Implications for NursingCommunity health center patients who have access to free DSME can improve their health, self-efficacy, and diabetes self-management practices.

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Abstract 15858: Efficacy of Hypertension Self-management Classes Among Low-Income Patients of a Federally Qualified Health Center

Circulation ◽

10.1161/circ.142.suppl_3.15858 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Cameron Eck ◽

Holly Biola ◽

Dominique Bulgin ◽

Colette A Whitney ◽

Melanie Bakovic ◽

...

Keyword(s):

Blood Pressure ◽

High Risk ◽

Low Income ◽

Community Setting ◽

Heart Association ◽

Self Management ◽

Self Monitoring ◽

Class Attendance ◽

Hispanic Patients ◽

Risk Patients

Introduction: Racial and socioeconomic disparities in hypertension prevalence and treatment have been observed over numerous decades. There is opportunity to close racial disparities by focusing resources on patient education, skill-building, and self-management. Methods: A hypertension-reduction program was established between an academic-affiliated FQHC in the southeast, the American Heart Association, the Centers for Disease Control, and the American College of Preventive Medicine using a multidisciplinary outreach model in the community setting. Participants included 265 high-risk patients from the FQHC with severe hypertension (>160/90 mm HG). Program activities included a weekly class where participants learned about hypertension, were trained to take their blood pressure (BP), and received cuffs to use at home. A prospective pre-post cohort design was used to evaluate this portion of the program. Participants’ attendance at the self-management classes was tracked along with BP measurements at every class attended. Results: Over the program’s first 6 months, 93 of the 265 recruited participants attended at least one of 28 BP management classes. The 29 participants who attended multiple classes achieved an average 19 mm HG reduction in systolic BP ( p =0.004) and an average 14 mm HG reduction in diastolic BP ( p =0.002). Patients who were Black were significantly more likely to attend multiple classes than patients who were Hispanic ( p =0.004). Also, patients who were self-monitoring their BP prior to class attendance were significantly more likely to attend multiple classes than those who were not previously self-monitoring ( p =0.014). Multiple class attendance was also associated with higher baseline BP ( p =0.038 for systolic and p =0.018 for diastolic). Conclusions: Implementation of blood pressure self-management classes showed success in reducing hypertension among many of the high-risk participants. Hispanic patients were much less likely to attend multiple classes, underscoring the need for culturally and linguistically appropriate class content. The low proportion of Hispanic patients previously monitoring their BP points to an opportunity to improve patient awareness about hypertension among Hispanic populations generally.

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State of Diabetes Self-Management Education in the European Union Member States and Non-EU Countries: The Diabetes Literacy Project

Journal of Diabetes Research ◽

10.1155/2018/1467171 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Henna Riemenschneider ◽

Sarama Saha ◽

Stephan van den Broucke ◽

Helle Terkildsen Maindal ◽

Gerardine Doyle ◽

...

Keyword(s):

Low Income ◽

Management Education ◽

Self Management ◽

The European Union ◽

Care Providers ◽

Member States ◽

Eu Countries ◽

Eu Member States ◽

Diabetes Literacy ◽

The Eu

Background. Diabetes self-management education (DSME) is considered essential for improving the prevention and care of diabetes through empowering patients to increase agency in their own health and care processes. However, existing evidence regarding DSME in the EU Member States (EU MS) is insufficient to develop an EU-wide strategy. Objectives. This study presents the state of DSME in the 28 EU MS and contrasts it with 3 non-EU countries with comparable Human Development Index score: Israel, Taiwan, and the USA (ITU). Because type 2 diabetes mellitus (T2DM) disproportionately affects minority and low-income groups, we paid particular attention to health literacy aspects of DSME for vulnerable populations. Methods. Data from multiple stakeholders involved in diabetes care were collected from Feb 2014 to Jan 2015 using an online Diabetes Literacy Survey (DLS). Of the 379 respondents (249 from EU MS and 130 from ITU), most were people with diabetes (33% in the EU MS, 15% in ITU) and care providers (47% and 72%). These data were supplemented by an expert survey (ES) administered to 30 key informants. Results. Access to DSME varies greatly in the EU MS: an average of 29% (range 21% to 50%) of respondents report DSME programs are tailored for people with limited literacy, educational attainment, and language skills versus 63% in ITU. More than half of adult T2DM patients and children/adolescents participate in DSME in EU MS; in ITU, participation of T1DM patients and older people is lower. Prioritization of DSME (6.1 ± 2.8 out of 10) and the level of satisfaction with the current state of DSME (5.0 ± 2.4 out of 10) in the EU MS were comparable with ITU. Conclusion. Variation in availability and organization of DSME in the EU MS presents a clear rationale for developing an EU-wide diabetes strategy to improve treatment and care for people with diabetes.

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473-P: Feasibility and Acceptability of a Direct-to-Home Diabetes Self-Management Education and Support Telemedicine Program (DSMES) with High-Risk Patients in a Rural, Underserved Area

Diabetes ◽

10.2337/db21-473-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 473-P

Author(s):

JODI S. KRALL ◽

JASON NG ◽

PATRICIA A. JOHNSON ◽

SHARI L. REYNOLDS ◽

LINDA M. SIMINERIO

Keyword(s):

High Risk ◽

Management Education ◽

Self Management ◽

Underserved Area ◽

High Risk Patients ◽

Risk Patients

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An Empowerment-Based Diabetes Self-management Education Program for Hispanic/Latinos

The Diabetes Educator ◽

10.1177/0145721711423319 ◽

2011 ◽

Vol 37 (6) ◽

pp. 770-779 ◽

Cited By ~ 28

Author(s):

Ninfa C. Peña-Purcell ◽

May M. Boggess ◽

Natalia Jimenez

Keyword(s):

Low Income ◽

Education Program ◽

Self Efficacy ◽

Management Education ◽

Intervention Group ◽

Self Care ◽

Self Management ◽

Repeated Measures Design ◽

Spanish Speaking ◽

Hispanic Latinos

Purpose The purpose of this pilot study was to evaluate the effects of a culturally sensitive, empowerment-based diabetes self-management education program for Spanish-speaking Hispanic/Latinos. Methods A prospective quasi-experimental repeated measures design tested the effectiveness of the ¡Si, Yo Puedo Controlar Mi Diabetes! diabetes self-management education program. In sum, 144 persons residing in 2 Texas counties at the Texas-Mexico border (Starr and Hidalgo) served as participants. Two groups were formed, an intervention and a control (wait list). Clinical (A1C), cognitive, attitudinal, behavioral, and cultural assessments were collected at baseline and 3 months. Results Demographic characteristics for the intervention and control groups were similar. Both groups were predominately female, low income, older than 40 years, and minimally acculturated. Baseline and posttest findings showed that the intervention group had a significant reduction in A1C values; median difference was 0.3 (n = 45), especially for those with higher baseline values. Participants in the intervention group also improved in their self-efficacy and self-care scores. Conclusions Findings from the study suggest that additional dissemination of a diabetes self-management education program for Spanish-speaking Hispanic/Latinos is warranted to improve clinical outcomes and associated diabetes self-efficacy and self-care behaviors.

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Preferred Language and Asthma among Asian Americans

10.36650/nexus3.1_31-43_chenetal ◽

2005 ◽

Vol 3 (1) ◽

pp. 31-43 ◽

Cited By ~ 4

Author(s):

Cecilia Chen ◽

Doug Brugge ◽

Alice Leung ◽

Andrea Finkleman ◽

Weibo Lu ◽

...

Keyword(s):

Urban Communities ◽

Asian Americans ◽

Asian American ◽

Chinese Immigrant ◽

Housing Conditions ◽

Immigrant Populations ◽

Communities Of Color ◽

The Us ◽

Report Data ◽

Undiagnosed Asthma

Little is known about childhood asthma rates and severity in the Asian American population in the US. We screened convenience samples of recent Chinese immigrants and longtime Asian Americans using the Brief Pediatric Asthma Screen (BPAS) in Boston Chinatown. Our goal was to conduct an exploratory study that helped develop methodology for researching asthma in Chinese immigrant populations. About 15% of the children surveyed were reported to have doctor-diagnosed asthma. Over 18% had possible undiagnosed asthma as scored via a modification to the BPAs that was likely to increase responses consistent with undiagnosed asthma. The CDC estimates that 8.7% of children have a lifetime diagnosis of asthma. Studies examining asthma in children have consistently found that asthma rates are higher among children living in urban communities of color, which is reflected in this study’s findings. The only statistically significant predictor of asthma diagnosis in a logistic regression model was taking the survey in Chinese (p<0.001; R=0.62) suggesting that acquisition of English is an important factor. We note that there are difficulties associated with translation of the word “wheeze” into Chinese and discuss the problems associated with this key term in the BPAS. Finally we report data from a separate survey of housing conditions in Boston Chinatown. Housing conditions known or suspected to aggravate asthma were reported by respondents to be infrequent. More research is needed to distinguish true difference in prevalence from differential diagnosis of asthma.

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Influences on Diabetes Self-Management Education Participation in a Low-Income, Spanish-Speaking, Latino Population

Diabetes Spectrum ◽

10.2337/ds16-0046 ◽

2017 ◽

Vol 31 (1) ◽

pp. 47-57 ◽

Cited By ~ 3

Author(s):

Jill Testerman ◽

Dian Chase

Keyword(s):

Low Income ◽

Management Education ◽

Self Management ◽

Latino Population ◽

Spanish Speaking ◽

Education Participation

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Scalable solution for delivery of diabetes self-management education in Thailand (DSME-T): a cluster randomised trial study protocol

BMJ Open ◽

10.1136/bmjopen-2020-036963 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036963

Author(s):

Chaisiri Angkurawaranon ◽

Iliatha Papachristou Nadal ◽

Poppy Alice Carson Mallinson ◽

Kanokporn Pinyopornpanish ◽

Orawan Quansri ◽

...

Keyword(s):

Primary Care ◽

Cardiovascular Risk ◽

Low Income ◽

Standard Care ◽

Management Education ◽

Randomised Trial ◽

Self Management ◽

Haemoglobin A1c ◽

Culturally Tailored ◽

Cluster Randomised

IntroductionType 2 diabetes mellitus is among the foremost health challenges facing policy makers in Thailand as its prevalence has more than tripled over the last two decades, accounting for considerable death, disability and healthcare expenditure. Diabetes self-management education (DSME) programmes show promise in improving diabetes outcomes, but this is not routinely used in Thailand. This study aims to test a culturally tailored DSME model in Thailand, using a three-arm cluster randomised controlled trial comparing a nurse-led model, a peer-assisted model and standard care. We will test which model is effective and cost effective to improve cardiovascular risk and control of blood glucose among people with diabetes.Methods and analysis21 primary care units in northern Thailand will be randomised to one of three interventions, enrolling a total of 693 patients. The primary care units will be randomised (1:1:1) to participate in a culturally-tailored DSME intervention for 12 months. The three-arm trial design will compare effectiveness of nurse-led, peer-assisted (Thai village health volunteers) and standard care. The primary trial outcomes are changes in haemoglobin A1c and cardiovascular risk score. A process evaluation and cost effectiveness evaluation will be conducted to produce policy relevant guidance for the Thai Ministry of Public Health. The planned trial period will start in January 2020 and finish October 2021.Ethics and disseminationEthical approval has been obtained from Thailand and the UK. We will share our study data with other researchers, advertising via our publications and web presence. In particular, we are committed to sharing our findings and data with academic audiences in Thailand and other low-income and middle-income countries.Trial registration numberNCT03938233.

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