Williams Ishan C, Utz Sharon W, Hinton Ivora, Yan Guofen, Jones Randy, Reid Kathryn
School of Nursing, University of Virginia, Charlottesville, Virginia (Dr Williams, Dr Utz, Dr Hinton, Dr Yan, Dr Jones, Dr Reid)
Department of Public Health, Charlottesville, Virginia (Dr Yan)
Diabetes Educ. 2014 Mar-Apr;40(2):231-9. doi: 10.1177/0145721713520570. Epub 2014 Jan 29.
The purpose of this study is to test the feasibility of conducting a community-based randomized controlled trial evaluating a culturally tailored community-based group diabetes self-management education (DSME) program among rural African Americans.
Thirty-two African American rural adults with type 2 diabetes were recruited and 25 adults were retained and participated in an interventional study designed to test the effectiveness of the "Taking Care of Sugar" DSME program for the 2-year follow-up. Participants were selected from rural central Virginia. Primary outcomes variables included average blood sugar levels, cardiovascular risk factors, and general physical and mental health. These outcomes were assessed at baseline, 3 months, 6 months, and 12 months post baseline.
From baseline to 3-month follow-up assessment, participants exhibited significant improvement on several physiological and behavioral measures. Given the small sample size, hypothesis testing was limited. Results show change from baseline over time, illustrating that the primary outcome of A1C decreased, although not significant. Additionally, participants reported more knowledge about diabetes self-management and personal care skills (ie, exercise and foot care) that persisted over time. The feasibility of the culturally tailored DSME was established, and participation with the program was high.
A community-based group DSME program using storytelling is feasible. This research will help to inform clinicians and health policymakers as to the types of interventions that are feasible in a larger rural population. If such a program is carried out, we can improve knowledge, reduce complications, and improve quality of life among rural African Americans.
本研究旨在检验开展一项基于社区的随机对照试验的可行性，该试验旨在评估一项针对非裔美国农村居民的、经过文化调适的基于社区的团体糖尿病自我管理教育（DSME）项目。
招募了32名患有2型糖尿病的非裔美国农村成年人，其中25名成年人被保留并参与了一项干预性研究，该研究旨在测试“关爱血糖”DSME项目在2年随访期内的有效性。参与者选自弗吉尼亚州中部农村地区。主要结局变量包括平均血糖水平、心血管危险因素以及总体身心健康状况。这些结局在基线、基线后3个月、6个月和12个月时进行评估。
从基线到3个月随访评估，参与者在多项生理和行为指标上有显著改善。鉴于样本量较小，假设检验受到限制。结果显示随时间推移与基线相比有变化，表明糖化血红蛋白（A1C）的主要结局有所下降，尽管不显著。此外，参与者报告了更多关于糖尿病自我管理和个人护理技能（如运动和足部护理）的知识，且这些知识随时间持续存在。经过文化调适的DSME的可行性得到确立，且项目参与度较高。
采用讲故事方式的基于社区的团体DSME项目是可行的。这项研究将有助于告知临床医生和卫生政策制定者在更大规模农村人口中可行的干预措施类型。如果实施这样一个项目，我们可以提高农村非裔美国人的知识水平、减少并发症并改善生活质量。
