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Development and implementation of a culturally tailored diabetes intervention in primary care

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Translational Behavioral Medicine

ABSTRACT

Diabetes education for ethnic minorities should address variations in values underlying motivations, preferences, and behaviors of individuals within an ethnic group. This paper describes the development and implementation of a culturally tailored diabetes intervention for Puerto Ricans that can be delivered by a health care paraprofessional and implemented in routine clinical care. We describe a formative process, including interviews with providers, focus groups with patients and a series of multidisciplinary collaborative workshops used to inform intervention content. We highlight the intervention components and link them to a well-validated health behavior change model. Finally, we present support for the intervention’s clinical effects, feasibility, and acceptability and conclude with implications and recommendations for practice. Lessons learned from this process should guide future educational efforts in routine clinical care.

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Acknowledgments

We thank Demetria N. Cain, Luis Casillas, Andrew Dudley, Matt Dudley, Jill Irvine, Melissa Johnson, Beth La Pierre, Scott McCarthy, Erin Paice, Jane Quale, and Iliri Ibrahimi for their assistance in preparing intervention materials. Special thanks to Carmen Aponte, Chariunis Perez, and Rosemary Perez for study recruitment, and collecting and managing data; and Charlene Aponte for delivering the intervention. The study was supported by an American Psychological Association dissertation award and a pilot grant award from the Center for Health Intervention and Prevention at the University of Connecticut, Storrs, CT. Dr. Osborn conducted this research under an NIH/NIDDK National Research Service Award (F31 DK067022), and is currently supported by a NIH/NIDDK Career Development Award (K01 DK087894). Dr. Pérez-Escamilla’s contribution to this manuscript was partially supported by the Connecticut Center for Eliminating Health Disparities among Latinos with funding from the NIH/NCMHD (P20 MD001765). The authors have no conflict of interest.

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Authors and Affiliations

  1. Division of General Internal Medicine & Public Health, Center for Health Services Research, Department of Medicine, Vanderbilt University Medical Center, 1215 Twenty-First Ave South, Suite 6000, MCE-North Tower, Nashville, TN, 37232-8300, USA

    Chandra Y Osborn PhD, MPH

  2. Diabetes Research and Training Center, Vanderbilt Eskind Diabetes Center, Vanderbilt University, Medical Center, Nashville, TN, USA

    Chandra Y Osborn PhD, MPH

  3. Center for Health Intervention and Prevention, University of Connecticut, Storrs, CT, USA

    K Rivet Amico PhD, Seth C Kalichman PhD & Jeffrey D Fisher PhD

  4. HumanaCares, St. Petersburg, FL, USA

    Noemi Cruz RD, CDE

  5. Department of Epidemiology and Public Health, Yale University, New Haven, CT, USA

    Rafael Perez-Escamilla PhD

  6. Center for Eliminating Health Disparities among Latinos, University of Connecticut, Storrs, CT, USA

    Rafael Perez-Escamilla PhD

  7. Department of Psychology, University of Connecticut, Storrs, CT, USA

    Seth C Kalichman PhD & Jeffrey D Fisher PhD

  8. Quantitative Research, Evaluation, and Measurement, The Ohio State University, Columbus, OH, USA

    Ann A O’Connell EdD

  9. Mercy Medical Center, Springfield, MA, USA

    Scott A Wolf DO, MPH

Authors
  1. Chandra Y Osborn PhD, MPH
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  2. K Rivet Amico PhD
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  3. Noemi Cruz RD, CDE
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  4. Rafael Perez-Escamilla PhD
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  5. Seth C Kalichman PhD
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  6. Ann A O’Connell EdD
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  7. Scott A Wolf DO, MPH
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  8. Jeffrey D Fisher PhD
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Corresponding author

Correspondence to Chandra Y Osborn PhD, MPH.

Additional information

Implications

Practice: Diabetes interventions for Hispanics must account for subgroup-specific dialects, food practices, traditional dishes, and cultural norms in their content, materials, and images.

Policy: Funding agencies should support research studies that evaluate the reach, adoption, implementation, maintenance, and sustainability of effective tailored interventions.

Research: Investigators should explore ways to adopt tailored interventions into routine clinical care, accrue evidence of effectiveness across populations and organizations, and report lessons learned from their experiences.

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Osborn, C.Y., Amico, K.R., Cruz, N. et al. Development and implementation of a culturally tailored diabetes intervention in primary care. Behav. Med. Pract. Policy Res. 1, 468–479 (2011). https://doi.org/10.1007/s13142-011-0064-9

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  • DOI: https://doi.org/10.1007/s13142-011-0064-9

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