Purpose: The purpose of this study was to conduct a systematic evaluation of community-based participatory research (CBPR) interventions on diabetes outcomes. Understanding of effective CBPR interventions on diabetes outcomes is limited, and findings remain unclear.
Methods: A reproducible search strategy was used to identify studies testing CBPR interventions to improve diabetes outcomes, including A1C, fasting glucose, blood pressure, lipids, and quality of life. Pubmed, PsychInfo, and CINAHL were searched for articles published between 2010 and 2020. Using a CBPR continuum framework, studies were classified based on outreach, consulting, involving, collaborating, and shared leadership.
Results: A total of 172 were screened, and a title search was conducted to determine eligibility. A total of 16 articles were included for synthesis. Twelve out of the 16 studies using CBPR approaches for diabetes interventions demonstrated statistically significant differences in 1 or more diabetes outcomes measured at a postintervention time point. Studies across the spectrum of CBPR demonstrated statistically significant improvements in diabetes outcomes.
Conclusions: Of the 16 studies included for synthesis, 14 demonstrated statistically significant changes in A1C, fasting glucose, blood pressure, lipids, and quality of life. The majority of studies used community health workers (CHWs) to deliver interventions across group and individual settings and demonstrated significant reductions in diabetes outcomes. The evidence summarized in this review shows the pivotal role that CHWs and diabetes care and education specialists play in not only intervention delivery but also in the development of outward-facing diabetes care approaches that are person- and community-centered.
Purpose: The purpose of this study was to investigate factors associated with receiving diabetes spousal support in a sample of Korean immigrants with type 2 diabetes (T2DM) and to test whether disclosure (culture-specific factor) is a significant predictor of spousal support receipt in this group.
Methods: A cross-sectional survey was conducted with a convenience sample of 136 US community-dwelling Korean immigrants with T2DM ages 46 to 89 years old. Potential predictors were sociodemographic factors (age, gender, education, years in US), personal characteristics (quality of marriage and depression), diabetes severity (duration of diabetes, A1C, insulin use), diabetes self-management, diabetes worries/concerns (psychological factor), and disclosure of worries (cultural factor). The study used validated survey instruments including Diabetes Care Profile for spousal support received, Summary of Diabetes Self-Care Activities, Problem Area in Diabetes, and Diabetes Distress Disclosure Index. Descriptive statistics, correlations, and hierarchical multivariable linear regression models were conducted.
Results: Six predictors (education level, years spent in the US, glucose control status, diabetes self-management level, diabetes worries/concerns, and disclosure of diabetes worries) were significantly related to receiving spousal support. At least some college education, less time in the US, better glucose control (lower A1C), poor self-management, more diabetes worries, and more disclosure of diabetes worries/distress were associated with receiving higher level of spousal support. Disclosure was the strongest predictor.
Conclusion: Receiving spousal support for diabetes self-management among Korean immigrants is influenced by 6 factors identified in this study. Disclosing diabetes worries (cultural factor) is most impactful.
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