在西班牙裔社区中，患者及其家属参与文化定制的糖尿病自我管理教育。
Patient and family engagement in culturally-tailored diabetes self-management education in a Hispanic community.
作者信息
Deverts Denise J, Zupa Margaret F, Kieffer Edith C, Gonzalez Stephanie, Guajardo Claudia, Valbuena Felix, Piatt Gretchen A, Yabes Jonathan G, Lalama Christina, Heisler Michele, Rosland Ann-Marie
机构信息
Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Caring for Complex Chronic Conditions Research Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
University of Michigan Ann Arbor, Ann Arbor, MI, USA.
出版信息
Patient Educ Couns. 2025 May;134:108669. doi: 10.1016/j.pec.2025.108669. Epub 2025 Jan 17.
OBJECTIVES
Diabetes self-management education (DSME) is effective in improving outcomes among adults with diabetes (AWD); but engagement in DSME has been lower among Hispanic AWD. We examined factors predicting engagement of Hispanic AWD in culturally tailored DSME that included a family/friend 'support person'.
METHODS
222 predominantly Hispanic AWD enrolled in DSME with a support person (SP), half of the AWD-SP pairs participated in pair-focused ('FAM-ACT') DSME and the others in patient-focused DSME. Enrollment survey and health record-based participant characteristics were compared to program attendance data.
RESULTS
On average, AWD completed 3.8 of 6 and SPs 2.6 of 6 sessions. Engaged AWD (attended ≥4/6 DSME sessions) were more likely to live apart from their SP, have HbA1c ≥ 9 % (11.8 mmol/L), and currently prioritize diabetes among other competing demands. Engaged AWD in FAM-ACT were more likely to have SPs who also met engagement criteria (attended ≥3 DSME sessions), and SPs with pre-diabetes and high 'patient activation'.
CONCLUSIONS
Hispanic AWD who co-attended with family supporters, had higher glycemic levels, and ability to prioritize diabetes management were more engaged in culturally-tailored DSME.
PRACTICE IMPLICATIONS
Engaging family supporters and focusing on those with current health and personal motivation may increase Hispanic adult engagement in DSME.
目的
糖尿病自我管理教育（DSME）对改善成年糖尿病患者（AWD）的病情有效；但西班牙裔AWD参与DSME的比例较低。我们研究了预测西班牙裔AWD参与针对其文化特点量身定制的DSME（其中包括一名家人/朋友“支持人员”）的因素。
方法
222名主要为西班牙裔的AWD与一名支持人员（SP）一起参加了DSME，其中一半的AWD-SP组合参加了以组合为重点的（“家庭-行动”）DSME，其他组合参加了以患者为重点的DSME。将登记调查和基于健康记录的参与者特征与项目出勤数据进行比较。
结果
平均而言，AWD完成了6节课程中的3.8节，SP完成了6节课程中的2.6节。积极参与的AWD（参加了≥4/6节DSME课程）更有可能与他们的SP不住在一起，糖化血红蛋白（HbA1c）≥9%（11.8 mmol/L），并且目前在其他竞争需求中将糖尿病列为优先事项。参加“家庭-行动”DSME的积极参与的AWD更有可能有也符合参与标准（参加了≥3节DSME课程）的SP，以及患有糖尿病前期和“患者激活”程度高的SP。
结论
与家庭支持者共同参加、血糖水平较高且有能力将糖尿病管理列为优先事项的西班牙裔AWD更积极地参与了针对其文化特点量身定制的DSME。
实践意义
让家庭支持者参与进来，并关注那些目前有健康问题和个人积极性的人，可能会增加西班牙裔成年人对DSME的参与度。
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