Miyong T Kim1, Kim B Kim2, Boyun Huh3, Tam Nguyen4, Hae-Ra Han5, Lee R Bone6, David Levine7. 1. School of Nursing, University of Texas at Austin, Austin, Texas. Electronic address: kbkim@ikorean.org. 2. Korean Resource Center, Ellicott City, Maryland. 3. School of Nursing, University of California at San Francisco, San Francisco, California. 4. Connell School of Nursing, Boston College, Boston, Massachusetts. 5. School of Nursing, Johns Hopkins University, Baltimore, Maryland. 6. School of Public Health, Johns Hopkins University, Baltimore, Maryland. 7. School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Abstract
INTRODUCTION:Korean Americans are one of the most underserved ethnic/linguistic minority groups owing to cultural and institutional barriers; there is an urgent need for culturally competent diabetes management programs in the Korean American community for those with type 2 diabetes. The purpose of this study was to test the effectiveness of a community-based, culturally tailored, multimodal behavioral intervention program in an ethnic/linguistic minority group with type 2 diabetes. DESIGN: An RCT with waitlist comparison based on the Predisposing, Reinforcing, and Enabling Constructs in Education/environmental Diagnosis and Evaluation (PRECEDE)-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) and self-help models. Data were collected between September 2010 and June 2013 and were analyzed in August-December 2014. Statistical significance was set at p<0.05. SETTING/PARTICIPANTS: In a naturally occurring community setting, a total of 250 Korean Americans with type 2 diabetes were randomized into an intervention group (n=120) or a control group (n=130). INTERVENTION: The intervention consisted of key self-management skill-building activities through 12 hours of group education sessions, followed by integrated counseling and behavioral coaching by a team of RNs and community health workers. MAIN OUTCOME MEASURES: Primary (clinical) outcomes were hemoglobinA1c, glucose, total cholesterol, and low-density lipoprotein at baseline and at 3, 6, 9, and 12 months. Secondary (psychosocial and behavioral) outcomes included diabetes-related quality of life, self-efficacy, adherence to diabetes management regimen, and health literacy. RESULTS: During the 12-month project, the intervention group demonstrated 1.0%-1.3% (10.9-14.2 mmol/mol) reductions in hemoglobin A1c, whereas the control group achieved reductions of 0.5%-0.7% (5.5-7.7 mmol/mol). The differences between the two groups were statistically significant. The intervention group showed statistically significant improvement in diabetes-related self-efficacy and quality of life when compared with the control group. CONCLUSIONS: RN/community health worker teams equipped with culturally tailored training can be effective in helping an ethnic/linguistic minority group manage diabetes in the community.
RCT Entities:
INTRODUCTION: Korean Americans are one of the most underserved ethnic/linguistic minority groups owing to cultural and institutional barriers; there is an urgent need for culturally competent diabetes management programs in the Korean American community for those with type 2 diabetes. The purpose of this study was to test the effectiveness of a community-based, culturally tailored, multimodal behavioral intervention program in an ethnic/linguistic minority group with type 2 diabetes. DESIGN: An RCT with waitlist comparison based on the Predisposing, Reinforcing, and Enabling Constructs in Education/environmental Diagnosis and Evaluation (PRECEDE)-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) and self-help models. Data were collected between September 2010 and June 2013 and were analyzed in August-December 2014. Statistical significance was set at p<0.05. SETTING/PARTICIPANTS: In a naturally occurring community setting, a total of 250 Korean Americans with type 2 diabetes were randomized into an intervention group (n=120) or a control group (n=130). INTERVENTION: The intervention consisted of key self-management skill-building activities through 12 hours of group education sessions, followed by integrated counseling and behavioral coaching by a team of RNs and community health workers. MAIN OUTCOME MEASURES: Primary (clinical) outcomes were hemoglobin A1c, glucose, total cholesterol, and low-density lipoprotein at baseline and at 3, 6, 9, and 12 months. Secondary (psychosocial and behavioral) outcomes included diabetes-related quality of life, self-efficacy, adherence to diabetes management regimen, and health literacy. RESULTS: During the 12-month project, the intervention group demonstrated 1.0%-1.3% (10.9-14.2 mmol/mol) reductions in hemoglobin A1c, whereas the control group achieved reductions of 0.5%-0.7% (5.5-7.7 mmol/mol). The differences between the two groups were statistically significant. The intervention group showed statistically significant improvement in diabetes-related self-efficacy and quality of life when compared with the control group. CONCLUSIONS: RN/community health worker teams equipped with culturally tailored training can be effective in helping an ethnic/linguistic minority group manage diabetes in the community.
Authors: Barbara A Israel; Chris M Coombe; Rebecca R Cheezum; Amy J Schulz; Robert J McGranaghan; Richard Lichtenstein; Angela G Reyes; Jaye Clement; Akosua Burris Journal: Am J Public Health Date: 2010-09-23 Impact factor: 9.308
Authors: Hee-Jung Song; Hae-Ra Han; Jong-Eun Lee; Jiyun Kim; Kim B Kim; Tam Nguyen; Miyong T Kim Journal: Diabetes Educ Date: 2010-07-22 Impact factor: 2.140
Authors: Kim B Kim; Miyong T Kim; Hochang B Lee; Tam Nguyen; Lee R Bone; David Levine Journal: Am J Public Health Date: 2016-03-17 Impact factor: 9.308
Authors: Elisa K Tong; Tung T Nguyen; Penny Lo; Susan L Stewart; Ginny L Gildengorin; Janice Y Tsoh; Angela M Jo; Marjorie L Kagawa-Singer; Angela U Sy; Charlene Cuaresma; Hy T Lam; Ching Wong; Mi T Tran; Moon S Chen Journal: Cancer Date: 2016-08-26 Impact factor: 6.860