BACKGROUND:African American (AA) women with Type 2 diabetes mellitus (T2DM) in the rural south experience less weight loss and poorer glycemic control in traditional diabetes management programs compared to Caucasians. This paper describes the design, rationale, and baseline characteristics from an innovative community health worker (CHW) delivered intervention program in this population. METHODS/ DESIGN: This prospective trial randomized rural AA women with uncontrolled T2DM (HbA1c ≥ 7.0) to receive abehaviorally-centered, culturally-tailored lifestyle intervention during 16 contacts from a trained AA CHW or 16 approved diabetes educational mailings. Changes from baseline in glycosylated hemoglobin levels (HbA1c), blood pressure (BP), weight, body mass index (BMI), self-reported dietary and physical activity patterns, and psychosocial measures including diabetes distress, empowerment, depression, self-care, medication adherence, andlife satisfaction will be assessed at 6- and 12-months. BASELINE RESULTS:Two hundred AA women (mean age = 53.09 ± 10.89 years) with T2DM from impoverished rural communities were enrolled. Baseline data demonstrated profoundly uncontrolled diabetes of long term duration (mean HbA1c = 9.11 ± 1.82; mean BMI = 37.68 ± 8.20; mean BP = 134.51 ± 20.39/84.19 ± 11.68; 10.5 ± 0.7 years). Self-care behavior assessment revealed poor dietary and medication adherence and sedentary lifestyle. Most psychosocial measures ranged within normal limits. CONCLUSION: The present sample of AA women from impoverished rural communities exhibited significantly uncontrolled T2DM of long duration with associated obesity and poor lifestyle behaviors. An innovative CHW led lifestyle intervention may lead to more effective strategies for T2DM management in this population.
RCT Entities:
BACKGROUND: African American (AA) women with Type 2 diabetes mellitus (T2DM) in the rural south experience less weight loss and poorer glycemic control in traditional diabetes management programs compared to Caucasians. This paper describes the design, rationale, and baseline characteristics from an innovative community health worker (CHW) delivered intervention program in this population. METHODS/ DESIGN: This prospective trial randomized rural AA women with uncontrolled T2DM (HbA1c ≥ 7.0) to receive a behaviorally-centered, culturally-tailored lifestyle intervention during 16 contacts from a trained AA CHW or 16 approved diabetes educational mailings. Changes from baseline in glycosylated hemoglobin levels (HbA1c), blood pressure (BP), weight, body mass index (BMI), self-reported dietary and physical activity patterns, and psychosocial measures including diabetes distress, empowerment, depression, self-care, medication adherence, and life satisfaction will be assessed at 6- and 12-months. BASELINE RESULTS: Two hundred AA women (mean age = 53.09 ± 10.89 years) with T2DM from impoverished rural communities were enrolled. Baseline data demonstrated profoundly uncontrolled diabetes of long term duration (mean HbA1c = 9.11 ± 1.82; mean BMI = 37.68 ± 8.20; mean BP = 134.51 ± 20.39/84.19 ± 11.68; 10.5 ± 0.7 years). Self-care behavior assessment revealed poor dietary and medication adherence and sedentary lifestyle. Most psychosocial measures ranged within normal limits. CONCLUSION: The present sample of AA women from impoverished rural communities exhibited significantly uncontrolled T2DM of long duration with associated obesity and poor lifestyle behaviors. An innovative CHW led lifestyle intervention may lead to more effective strategies for T2DM management in this population.
Authors: Edwin B Fisher; Guadalupe X Ayala; Leticia Ibarra; Andrea L Cherrington; John P Elder; Tricia S Tang; Michele Heisler; Monika M Safford; David Simmons Journal: Ann Fam Med Date: 2015-08 Impact factor: 5.166
Authors: Lesley D Lutes; Laura J Damschroder; Robin Masheb; Hyungjin Myra Kim; Leah Gillon; Robert G Holleman; David E Goodrich; Julie C Lowery; Carol Janney; Susan Kirsh; Caroline R Richardson Journal: J Gen Intern Med Date: 2017-04 Impact factor: 5.128
Authors: Walter Palmas; Dana March; Salima Darakjy; Sally E Findley; Jeanne Teresi; Olveen Carrasquillo; José A Luchsinger Journal: J Gen Intern Med Date: 2015-03-04 Impact factor: 5.128
Authors: Marvin E Langston; Lindsay Fuzzell; Marquita W Lewis-Thames; Saira Khan; Justin X Moore Journal: LGBT Health Date: 2019-05-20 Impact factor: 4.151
Authors: J D Ard; T L Carson; J M Shikany; Y Li; C M Hardy; J C Robinson; A G Williams; M L Baskin Journal: J Intern Med Date: 2017-05-17 Impact factor: 8.989