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将基于证据的糖尿病教育方法引入美国农村非裔社区:“智慧、力量、控制”项目

Translating an evidence-based diabetes education approach into rural african-american communities: the "wisdom, power, control" program.

作者信息

Peña-Purcell Ninfa C, Jiang Luohua, Ory Marcia G, Hollingsworth Ryan

机构信息

AgriLife Extension Service, Texas A&M University, College Station, TX.

Department of Epidemiology, School of Medicine, University of California Irvine, Irvine, CA.

出版信息

Diabetes Spectr. 2015 May;28(2):106-15. doi: 10.2337/diaspect.28.2.106.

Abstract

Purpose. The aim of this exploratory study was to assess the efficacy of the "Wisdom, Power, Control" diabetes self-management education (DSME) program with regard to diabetes knowledge, self-efficacy, self-care, distress level, and A1C in an African-American population. Methods. A prospective, quasi-experimental, repeated-measure design was employed to measure these outcomes. Study participants were assessed at baseline, 6 weeks post-intervention, and at a 3-month A1C follow-up. Results. A total of 103 participants were recruited from the intervention counties, and 14 were identified from the control counties. At the post-test, participants in the intervention group reported a significantly higher level of diabetes knowledge (Δ = 9.2%, P <0.0001), higher self-efficacy (Δ = 0.60, P <0.0001), more self-care behaviors (Δ = 0.48, P <0.0001), lower distress level (Δ = -0.15, P = 0.05), and higher health status (Δ = 0.49, P = <0.0001). About 56% of the intervention group completed all six classes, and 25% attended five classes. Conclusions. Findings from this study demonstrate the initial success of translating a culturally adapted DSME program into rural African-American communities. The study highlights important lessons learned in the process of implementing this type of program in a real-world setting with a minority population.

摘要

目的。本探索性研究旨在评估“智慧、力量、控制”糖尿病自我管理教育(DSME)项目在非裔美国人中对糖尿病知识、自我效能、自我护理、痛苦程度和糖化血红蛋白(A1C)的效果。方法。采用前瞻性、准实验性、重复测量设计来测量这些结果。研究参与者在基线、干预后6周以及3个月A1C随访时接受评估。结果。从干预县招募了总共103名参与者,从对照县识别出14名。在测试后,干预组参与者报告糖尿病知识水平显著更高(Δ = 9.2%,P <0.0001)、自我效能更高(Δ = 0.60,P <0.0001)、自我护理行为更多(Δ = 0.48,P <0.0001)、痛苦程度更低(Δ = -0.15,P = 0.05)以及健康状况更好(Δ = 0.49,P = <0.0001)。干预组约56%的人完成了所有六节课,25%的人参加了五节课。结论。本研究结果表明将经过文化适应的DSME项目引入农村非裔美国人社区初步取得成功。该研究突出了在现实环境中针对少数族裔人群实施这类项目过程中学到的重要经验教训。

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