Diabetes Educator最新文献

Purpose: The purpose of this study was to explore diabetes in adults experiencing homelessness by evaluating diabetes risk, A1C measurement, and achievement of the goals of the American Diabetes Association (ADA) Standards of Medical Care in Diabetes.

Methods: Project Homeless Connect Omaha is a 1-day health and social services event for adults who are homeless. The event seeks to meet immediate needs, identify potential future needs, and provide a connection with community resources for further follow-up for these adults. Health professions students and faculty from the university where the event is held volunteer their time to provide these services. Risk assessment for type 2 diabetes, A1C measurement, and evaluation of the ADA Standards of Medical Care were available for participants of this event.

Results: Of the 478 participants who completed a risk assessment for diabetes, 91 underwent rapid A1C testing. Four participants at the diabetes station (4%) were newly identified as having diabetes with elevated A1C, and 32% of the participants had elevated A1C levels demonstrating prediabetes. Twelve individuals reported being previously diagnosed with diabetes, and of those, 50% had A1C levels between 7.3% and >13% (56 to 119 mmol/mol). Participants whose A1Cs classified them as having prediabetes or diabetes (n = 40) completed an evaluation of standards of medical care goals. Participants identified eye, foot, and dental examinations; lipid management; and urine protein screening as some of the areas in which the standards were not yet achieved.

Conclusion: Adults experiencing homelessness have a significant need for diabetes screening and management. Diabetes educators can provide education to equip adults with the ability to effectively manage their illness and prevent complications.

Purpose: The purpose of the study is to test the effects of a culturally tailored family-based self-management education and social support intervention on family social capital with Mexican American (MA) adults with type 2 diabetes (T2DM) and their family member.

Methods: Using a 2-group, experimental repeated-measures design, 157 dyads were randomly assigned to an intervention (group education and social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, immediately postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated-measures analyses of variance with interaction contrasts were used to test the hypotheses regarding the differential effects on family social capital.

Results: Social capital outcomes included social integration, social support, and family efficacy. Social integration scores, high for family members and friends and low for community engagement, did not change over time for participants or family members. Participants perceived high support from family for physical activity with an immediate increase postintervention and moderate sabotage for healthy eating with no change over time. A sustained intervention effect was noted for family efficacy for general health and total family efficacy in participants and family members.

Conclusions: This family-based culturally tailored intervention demonstrated the potential to improve social capital, specifically social support for physical activity and family efficacy for diabetes management for MA adults with T2DM. Ongoing research that examines the family as a critical context in which T2DM self-management occurs and that targets strategies for sustained family social capital outcomes for T2DM is needed.

Purpose: The purpose of the study was to examine whether a peer coaching intervention is more effective in improving clinical outcomes in diabetes when enhanced with e-health educational tools than peer coaching alone.

Methods: The effectiveness of peer coaches who used an individually tailored, interactive, web-based tool (iDecide) was compared with peer coaches with no access to the tool. Two hundred and ninety Veterans Affairs patients with A1C ≥8.0% received a 6-month intervention with an initial session with a fellow patient trained to be a peer coach, followed by weekly phone calls to discuss behavioral goals. Participants were randomized to coaches who used iDecide or coaches who used nontailored educational materials at the initial session. Outcomes were A1C (primary), blood pressure, and diabetes social support (secondary) at 6 and 12 months.

Results: Two hundred and fifty-five participants (88%) completed 6-month and 237 (82%) 12-month follow-up. Ninety-eight percent were men, and 63% were African American. Participants in both groups improved A1C values (>-0.6%, P < .001) at 6 months and maintained these gains at 12-month follow-up ( >-0.5%, P < .005). Diabetes social support was improved at both 6 and 12 months ( P < .01). There were no changes in blood pressure.

Conclusions: Clinical gains achieved through a volunteer peer coach program were not increased by the addition of a tailored e-health educational tool.