Your browser doesn't support javascript.
loading
A patient-centered comparative effectiveness research study of culturally appropriate options for diabetes self-management.
Page-Reeves, Janet; Murray-Krezan, Cristina; Burge, Mark R; Mishra, Shiraz I; Regino, Lidia; Bleecker, Molly; Perez, Daniel; McGrew, Hannah Cole; Bearer, Elaine L; Erhardt, Erik.
Affiliation
  • Page-Reeves J; Department of Family & Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • Murray-Krezan C; Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • Burge MR; Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Mishra SI; Eli Lily and Company, Indianapolis, Indiana, USA.
  • Regino L; Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • Bleecker M; Department of Family & Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • Perez D; Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • McGrew HC; Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • Bearer EL; Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
  • Erhardt E; Connectus Health, Nashville, Tennessee, USA.
medRxiv ; 2023 Feb 08.
Article in En | MEDLINE | ID: mdl-36778329
ABSTRACT
This project compared the effectiveness of two evidence-based models of culturally competent diabetes health promotion The Diabetes Self-Management Support Empowerment Model (DSMS), and The Chronic Care Model (CCM). Our primary outcome was improvement in patient capacity for diabetes self-management as measured by the Diabetes Knowledge Questionnaire (DKQ) and the Patient Activation Measure (PAM). Our secondary outcome was patient success at diabetes self-management as measured by improvement in A1c, depression sores using the PHQ-9, and Body Mass Index (BMI). We also gathered data on the cultural competence of the program using the Consumer Assessment of Healthcare Providers and Systems Cultural Competence Set (CAHPS-CC). We compared patient outcomes in two existing sites in Albuquerque, New Mexico that serve a large population of Latino diabetes patients from low-income households. Participants were enrolled as dyads-a patient participant (n=226) and a social support participant (n=226). Outcomes over time and by program were analyzed using longitudinal linear mixed modeling, adjusted for patient participant demographic characteristics and other potential confounding covariates. Secondary outcomes were also adjusted for potential confounders. Interactions with both time and program helped to assess outcomes. This study did not find a difference between the two sites with respect to the primary outcome measures and only one of the three secondary outcomes showed differential results. The main difference between programs was that depression decreased more for CCM than for DSMS. An exploratory, subgroup analysis revealed that at CCM, patient participants with a very high A1c (>10) demonstrated a clinically meaningful decrease. However, given the higher cultural competence rating for the CCM, statistically significant improvement in depression, and the importance of social support to the patients, results suggest that a culturally and contextually situated diabetes self-management and education program design may deliver benefit for patients, especially for patients with higher A1c levels.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Prognostic_studies Language: En Journal: MedRxiv Year: 2023 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Prognostic_studies Language: En Journal: MedRxiv Year: 2023 Document type: Article Affiliation country: