Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 S. Maryland Ave, MC 2007, Room B 228, Chicago, IL 60637 USA ; Diabetes Research and Training Center, University of Chicago, Chicago, IL USA ; Center for Health and the Social Sciences, University of Chicago, Chicago, IL USA ; Center for the Study of Race, Politics and Culture, University of Chicago, Chicago, IL USA.
Transl Behav Med. 2012 Sep;2(3):296-308. doi: 10.1007/s13142-012-0125-8.
New translational strategies are needed to improve diabetes outcomes among low-income African-Americans. Our goal was to develop/pilot test a patient intervention combining culturally tailored diabetes education with shared decision-making training. This was an observational cohort study. Surveys and clinical data were collected at baseline, program completion, and 3 and 6 months. There were 21 participants; the mean age was 61 years. Eighty-six percent of participants attended >70 % of classes. There were improvements in diabetes self-efficacy, self-care behaviors (i.e., following a "healthful eating plan" (mean score at baseline 3.4 vs. 5.2 at program's end; p = 0.002), self glucose monitoring (mean score at baseline 4.3 vs. 6.2 at program's end; p = 0.04), and foot care (mean score at baseline 4.1 vs. 6.0 at program's end; p = 0.001)), hemoglobin A1c (8.24 at baseline vs. 7.33 at 3-month follow-up, p = 0.02), and HDL cholesterol (51.2 at baseline vs. 61.8 at 6-month follow-up, p = 0.01). Combining tailored education with shared decision-making may be a promising strategy for empowering low-income African-Americans and improving health outcomes.
需要新的转化策略来改善低收入非裔美国人的糖尿病治疗效果。我们的目标是开发/试点测试一种将文化适应的糖尿病教育与共同决策培训相结合的患者干预措施。这是一项观察性队列研究。在基线、项目完成以及 3 个月和 6 个月时收集了调查和临床数据。共有 21 名参与者,平均年龄为 61 岁。86%的参与者参加了超过 70%的课程。糖尿病自我效能感、自我护理行为(即遵循“健康饮食计划”(基线时的平均得分 3.4 分,项目结束时的平均得分 5.2 分;p=0.002)、自我血糖监测(基线时的平均得分 4.3 分,项目结束时的平均得分 6.2 分;p=0.04)和足部护理(基线时的平均得分 4.1 分,项目结束时的平均得分 6.0 分;p=0.001))、糖化血红蛋白(基线时为 8.24,3 个月随访时为 7.33,p=0.02)和高密度脂蛋白胆固醇(基线时为 51.2,6 个月随访时为 61.8,p=0.01)有所改善。将量身定制的教育与共同决策相结合,可能是增强低收入非裔美国人能力和改善健康结果的一种有前途的策略。