The School of Nursing, Johns Hopkins University, Baltimore, Maryland (Dr M. T. Kim, Dr Han, Dr Lee, Dr J. Kim)
The School of Public Health, Johns Hopkins University, Baltimore, Maryland (Dr Song)
Diabetes Educ. 2009 Nov-Dec;35(6):986-94. doi: 10.1177/0145721709345774.
The purpose of this study is to test the efficacy of a culturally tailored comprehensive type 2 diabetes management intervention for Korean American immigrants (KAIs) with type 2 diabetes.
A randomized controlled pilot trial with 2 parallel arms (intervention vs control) with a delayed intervention design was used. A total of 79 KAIs, recruited from the Baltimore-Washington area, completed baseline, 18-week, and 30-week follow-ups (intervention, n = 40; control, n = 39). All participants had uncontrolled type 2 diabetes (hemoglobin A1C >or=7.5%) at baseline. The authors' comprehensive, self-help intervention program for type 2 diabetes management (SHIP-DM) consisted of a 6-week structured psychobehavioral education, home glucose monitoring with teletransmission, and bilingual nurse telephone counseling for 24 weeks. The primary outcome of the study was A1C level, and secondary outcomes included an array of psychobehavioral variables.
Using analysis of covariance, the findings support that the proposed intervention was effective in significantly lowering A1C and fasting glucose and also in improving psychosocial outcomes in the sample. Specifically, the amount of reduction in A1C among intervention group participants was 1.19% at 18 weeks and 1.31% at 30 weeks, with 10% and 15.5% of the participants achieving the suggested goal of A1C <7% at 18 and 30 weeks of follow-up, respectively.
The results highlight the clinical efficacy of the SHIP-DM intervention composed of a 6-week education program, self-monitoring, and follow-up counseling, in terms of maintaining the improved intervention effects obtained and in terms of glucose control.
本研究旨在测试一种针对 2 型糖尿病韩裔美国移民（KAIs）的文化适应综合 2 型糖尿病管理干预措施的疗效。
采用随机对照试点试验，设有 2 个平行组（干预组与对照组）和延迟干预设计。共有 79 名从巴尔的摩-华盛顿地区招募的 KAIs 完成了基线、18 周和 30 周随访（干预组 n=40；对照组 n=39）。所有参与者在基线时均患有未控制的 2 型糖尿病（糖化血红蛋白 A1C≥7.5%）。作者的 2 型糖尿病综合自我帮助管理干预方案（SHIP-DM）包括为期 6 周的结构化心理行为教育、家庭血糖监测和双语护士电话咨询，共 24 周。研究的主要结果是 A1C 水平，次要结果包括一系列心理行为变量。
使用协方差分析，研究结果表明，所提出的干预措施在降低 A1C 和空腹血糖方面以及改善样本中的心理社会结果方面是有效的。具体来说，干预组参与者的 A1C 降低量在 18 周时为 1.19%，在 30 周时为 1.31%，分别有 10%和 15.5%的参与者在 18 和 30 周的随访中达到了 A1C<7%的建议目标。
结果突出了由 6 周教育计划、自我监测和后续咨询组成的 SHIP-DM 干预在维持已获得的干预效果和血糖控制方面的临床疗效。
