Outcomes from a Diabetes Self-management Intervention for Native Hawaiians and Pacific People: Partners in Care
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Culturally adapted interventions are needed to reduce diabetes-related morbidity and mortality among Native Hawaiian and Pacific People.
The purpose of this study is to pilot test the effectiveness of a culturally adapted diabetes self-management intervention.
Participants were randomly assigned in an unbalanced design to the Partners in Care intervention (n = 48) or wait list control group (n = 34). Assessments of hemoglobin A1c, understanding of diabetes self-management, performance of self-care activities, and diabetes-related distress were measured at baseline and 3 months (post intervention). Analysis of covariance was used to test between-group differences. The community steering committee and focus group data informed the cultural adaptation of the intervention.
There were significant baseline adjusted differences at 3 months between the Partners in Care and wait list control group in intent-to-treat (p < 0.001) and complete case analyses (p < 0.0001) for A1c, understanding (p < 0.0001), and performing diabetes self-management (p < 0.0001).
A culturally adapted diabetes self-management intervention of short duration was an effective approach to improving glycemic control among Native Hawaiian and Pacific Islanders.
- National Institutes of Health: Strategic Plan on Minority Health Disparities. Retrieved November 20, 2011 from http://www2.niddk.nih.gov/AboutNIDDK/ReportsAndStrategicPlanning/Strategic_Plan_Minority_Health_Disparities.htm
- American Diabetes Association. Economic consequences of diabetes mellitus in the US in 2002. Diabetes Care. 2003;26:917-932. CrossRef
- U.S. Census Bureau: State of Hawaii 2010 Census Demographic Profile. Retrieved May 6, 2012 from http://hawaii.gov/dbedt/info/census/Census_2010/demographic
- The Kaiser Family Foundation: State Health Facts. Data Source: Behavioral Risk Factor Surveillance System, 2008; analysis by the National Center for Chronic Disease Prevention and Health Promotion, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, available at http://apps.nccd.cdc.gov/BRFSS/list.asp?cat=DB&yr=2008&qkey=1363&state=All. Retrieved September, 2009, from statehealthfacts.org
- Grandinetti A, Kaholokula JK, Theriault AG, et al. Prevalence of diabetes and glucose intolerance in an ethnically diverse rural community of Hawaii. Ethn Dis. 2007;17:250-255.
- Salvail F, Nguyen D: Have you ever been told by a doctor that you have diabetes? Retrieved April 6, 2009
- Grandinetti A, Mau M, Curb J, et al. Prevalence of glucose intolerance among Native Hawaiians in two rural communities. Diabetes Care. 1998;21:549-554. CrossRef
- Maskarinec G. Diabetes in Hawaii: Estimating prevalence from insurance claims data. AJPH. 1997;87:1717-1720. CrossRef
- TransPacific Renal Network: Selected Demographics 2000. San Rafael, CA: TransPacific Renal Network, 2001.
- United States Census Bureau: Census 2000 profiles of general demographic characteristics: Hawaii. In U.S. Census Bureau (ed). Washington, D.C., 2001.
- Cox D, Gonder-Frederick L. Major developments in behavioral diabetes research. J Cons Clin Psych. 1992;60:628-638. CrossRef
- Funnell M, Brown T, Childs B, et al. National standards for diabetes self-management education. Diabetes Care. 2007;30:1630-1637. CrossRef
- Huang T, Salvail F, Nguyen D, et al: Adult diabetes prevalence measured from the HBRFSS. Honolulu, HI: Hawaii State Department of Health, 2004.
- Furubayashi J, Look M. Type 2 diabetes in Native Hawaiians and Pacific Islanders in Hawaii. Pac Health Dialog. 2005;12:103-110.
- Brown S. Effects of educational interventions in diabetes care: A meta-analysis of findings. Nurs Res. 1988;37:223-230.
- Norris S, Engelgau M, Narayan V. Effectiveness of self-management training in type 2 diabetes: A systematic review of randomized controlled trials. Diabetes Care. 2001;24:561-587. CrossRef
- Norris S, Lau J, Smith S, Schmid C, Engelgau M. Self-management education for adults with type 2 diabetes. Diabetes Care. 2002;25:1159-1171. CrossRef
- Wing R, Goldstein M, Acton K, Birch L, et al. Behavioral science research in diabetes: Lifestyle changes related to obesity, eating behavior, and physical activity. Diabetes Care. 2001;24:117-123. CrossRef
- Whittemore R. Strategies to facilitate lifestyle change associated with diabetes mellitus. J Nurs Scholarship. 2000;32:225-232. CrossRef
- Appel L. Lifestyle modification as a means to prevent and treat high blood pressure. J Am Soc Nephrol. 2003;14:S99-S102. CrossRef
- Program TDP. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. NEJM. 2002;346:393-403. CrossRef
- Boule N, Haddad E, Kenny G, Wells G, Sigal R. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus. JAMA. 2001;286:1218-1227. CrossRef
- Gary T, Genkinger J, Guallar E, Peyrot M, Brancati F. Meta-analysis of randomized educational and behavioral intervention in type 2diabetes. Diabetes Educator. 2003;29:488-501. CrossRef
- The Diabetes Prevention Program Study Group. The Diabetes Prevention Program: Description of the lifestyle intervention. Diabetes Care. 2002;25:2165-2171. CrossRef
- Mau M, Sinclair K, Saito E, Baumhofer K, Kaholokula J. Cardiometabolic health disparities in Native Hawaiians and other Pacific People. Epidmiol Rev. 2009;31:113-129. CrossRef
- Nacapoy AH, Kaholokula JK, West MR, et al. Partnerships to address obesity disparities in Hawai'i: The PILI 'Ohana Project. Hawaii Med J. 2008;67:237-241.
- Two Feathers J, Kieffer E, Palmisano G, et al.: Racial and Ethnic Approaches to Community Health (REACH) Detroit Partnership: Improving diabetes-related outcomes among African American and Latino adults. AJPH. 2005, 95.
- Spencer M, Rosland A, Kieffer E, et al. Effectiveness of a community health worker intervention among African American and Latino adults with type 2 diabetes: A randomized controlled trial. AJPH. 2011;101:2253-2260. CrossRef
- Two Feathers J, Kieffer E, Palmisano G, et al. The development, implementation and process evaluation of the REACH Detroit diabetes lifestyle intervention. Diabetes Educator. 2007;33:509-520. CrossRef
- Kreuter M, Lukwago S, Bucholtz D, Clark E, Sanders-Thompson V. Achieving cultural appropriateness in health promotion programs: Targeted and tailored approaches. Health Educ Behav. 2003;30:133-146. CrossRef
- Standards of medical care in diabetes. 2010; Diabetes Care. 2010: 33 Suppl 1:S11–61.
- Bandura A: Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall, 1986.
- Baranowski T, Perry C, Parcel G: How individuals, environments, and health behavior interact: Social Cognitive Theory (2nd Ed.). San Francisco: Jossey-Bass, 1997.
- Fitzgerald J, Davis W, Connell C, et al. Development and validation of the Diabetes Care Profile. Eval Health prof. 1996;19:208-230. CrossRef
- Fitzgerald JT, Anderson RM, Gruppen LD, et al. The reliability of the Diabetes Care Profile for African Americans. Eval Health prof. 1998;21:52-65. CrossRef
- Cunningham V, Mohler M, Wendel C, et al. Reliability and validity of the DCP among hispanic veterans. Eval Health prof. 2005;28:447-463. CrossRef
- Toobert D, Hampson S, Glasgow R. The summary of diabetes self-care activities measure: Results from 7 studies and a revised scale. Diabetes Care. 2000;23:943-950. CrossRef
- Polonsky W, Anderson B, Lohrer P, et al. Assessment of diabetes-related distress. Diabetes Care. 1995;18:754-760. CrossRef
- United Kingdom Prospective Diabetes Study Group (UKPDS). Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet. 1998;352:837-853. CrossRef
- Brown S. Meta-analysis of diabetes patient education research: Variations in intervention effects across subjects. Res Nurs Health. 1992;15:409-419. CrossRef
- Gilliland S, Azen S, Perez G, Carter J. Strong in body and spirit: Lifestyle intervention for Native American adults with diabetes in New Mexico. Diabetes Care. 2002;25:78-83. CrossRef
- Brown S, Garcia A, Kouzekanani K, Hanis C. Culturally competent diabetes self-management education for Mexican Americans. Diabetes Care. 2002;25:259-268. CrossRef
- Ciliska D, Miles E, O'Brien M, Turl C, et al. Effectiveness of community-based interventions to increase fruit and vegetable consumption. J Nutr Educ Behav. 2000;32:341-352. CrossRef
- Agurs-Collins T, Kumanyika S, Ten Have T, Adams-Campbell L. A randomized controlled trial of weight reduction and exercise for diabetes management in older African American subjects. Diabetes Care. 1997;20:1503-1511. CrossRef
- Lorig KR, Holman H. Self-management education: History, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26:1-7. CrossRef
- Warsi A, Wang P, LaValley M, Avorn J, Solomon D. Self-management education programs in chronic disease. Arch Intern Med. 2004;164:1641-1649. CrossRef
- Norris S, Nichols P, Caspersen C, et al. Increasing diabetes self-management education in community settings. Am J Prev Med. 2002;22:39-66. CrossRef
- Brown S, Hannis C. Culturally competent diabetes education for Mexican Americans: The Starr County Study. Diabetes Educ. 1999;25:226-236. CrossRef
- Khaw K, Wareham N, Luben R, et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk). BMJ. 2001;322:15-18. CrossRef
- Wagner E. Effect of improved glycemic control on health care costs and utilization. JAMA. 2001;285:182-189. CrossRef
- Outcomes from a Diabetes Self-management Intervention for Native Hawaiians and Pacific People: Partners in Care
Annals of Behavioral Medicine
Volume 45, Issue 1 , pp 24-32
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Health disparities
- Native Hawaiian and Pacific People
- Diabetes self-management
- Culturally adapted
- Randomized controlled trial
- Peer educators
- Industry Sectors
- Author Affiliations
- 1. Department of Native Hawaiian Health, University of Hawaii, 651 Ilalo Street, Honolulu, HI, 96813, USA
- 2. Ke Ola Mamo, 1505 Dillingham Blvd, Honolulu, HI, USA
- 3. Kula No Na Po’e Hawai’i, 2150 Tantalus Drive, Honolulu, HI, 96813, USA
- 4. Kokua Kalihi Valley Community Health Center, 2239 N. School St., Honolulu, HI, 96819, USA