Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 3, 2022
Date Accepted: Dec 25, 2022
Improving self-management of Type 2 diabetes in Latinx patients: Protocol for a sequential multiple assignment randomized trial using community health workers, registered nurses, and family members
ABSTRACT
Background:
The rate of Type 2 diabetes mellitus (T2DM) among Mexican Americans is 16.3%, about twice that of non-Hispanic Whites. While a number of education approaches have been developed and shown to improve diabetes self-management behaviors and glycemic control for Spanish-speaking Latinx patients with T2DM, there is little research to guide health practitioners regarding which interventions to apply and when so that resources are used efficiently, and treatment outcomes are maximized.
Objective:
To describe an adaptive intervention that integrates community mental health workers, diabetes nurse educators, family members, and patients as partners in care while promoting diabetes self-management for Mexican Americans with T2DM. The project incorporates four evidence-based, culturally tailored treatments to determine what sequence of intervention strategies work most efficiently and for whom. Given the increasing prevalence of T2DM, achieving better control of diabetes and lowering the associated medical complications experienced disproportionally by Mexican Americans is a public health priority.
Methods:
Funded by the National Institute of Nursing Research (NIH grant number R01 NR015809), this project utilized a Sequential Multiple Assignment Randomized Trial (SMART) and included 330 Spanish-speaking Latinx patients with T2DM. In the first phase of the study, subjects were randomly assigned to an evidence-based diabetes self-management education (DSME) called Tomando Control delivered in a group format for six, bi-weekly 1.5-hour sessions, led either by a community health worker or a diabetes nurse educator. In the second phase of the study, those subjects who did not improve their diabetes self-management behaviors were re-randomized to receive either an augmented version of the DSME or a multifamily group treatment focused on problem solving. The primary outcome measure was the “Summary of Diabetes Self-Care Activities.” Evaluations were made at baseline and at three, six, and 12 months.
Results:
The results of this study are pending data analysis.
Conclusions:
The results of this trial should help practitioners in selecting the optimal approach for improving diabetes self-management in Spanish-speaking, Latinx patients with T2DM. Clinical Trial: Clinical Trials ID# NCT03092063
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.