Impact of a Culturally Tailored Diabetes Education and Empowerment Program in a Mexican American Population Along the US/Mexico Border: A Pragmatic Study

作者：Silvia Flores-Luévano, Maricela Pacheco, Gurjeet S Shokar, Alok Kumar Dwivedi, Navkiran K. Shokar · 发表于：Journal of Clinical Medicine Research · 年份：2020 · DOI：10.14740/jocmr4273 · 被引用次数：27 · 研究领域：Diabetes Management and Education、Diabetes, Cardiovascular Risks, and Lipoproteins、Cultural Competency in Health Care

BACKGROUND: The study purpose was to deliver a diabetes education program under real world conditions and evaluate its effect on diabetes-related clinical, self-management and psychosocial outcomes among Mexican Americans residing along the US/Mexico border. METHODS: A pragmatic study was conducted among adult patients with diabetes in three primary care clinics located along the US/Mexico border. A bilingual culturally tailored diabetes education program incorporating hands-on participatory techniques was delivered in 4 - 8 weekly group sessions. Clinical, self-management and psychosocial outcomes were evaluated pre- and post-intervention with surveys and medical record review. RESULTS: A total of 209 participants were enrolled; mean age was 58.9 years (range 23 - 94, standard deviation: 11.2); 68.4% were female; 91.1% were Hispanic. Significant improvements were observed in glycated hemoglobin (-1.1%, P < 0.001, n = 79), total cholesterol (-17.2 mg/dL, P = 0.041, n = 63), glucose self-monitoring (+1.3 times a week, P = 0.021, n = 115), exercise less than once a week (-18.2%, P < 0.001, n = 129), nutritional behavior (+2.23, P < 0.001, n = 115), knowledge (+1. 83, P < 0.001, n = 141) and diabetes-related emotional distress (-7.32, P = 0.002, n = 111). Benefits were observed with attendance rates as low as 50%. CONCLUSION: A clinic-based culturally competent diabetes education/self-management program resulted in significant improvements in outcomes among Hispanic participants...