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Randomized trial of a literacy-sensitive, culturally tailored diabetes self-management intervention for low-income latinos: latinos en control
Preventive and Behavioral Medicine Publications and Presentations
  • Milagros C. Rosal, University of Massachusetts Medical School
  • Ira S. Ockene, University of Massachusetts Medical School
  • Angela Restrepo, University of Massachusetts Medical School
  • Mary Jo White, University of Massachusetts Medical School
  • Amy Borg, University of Massachusetts Medical School
  • Barbara C. Olendzki, University of Massachusetts Medical School
  • Jeffrey Scavron, Brightwood Health Center/Tufts University
  • Lucy M. Candib, University of Massachusetts Medical School
  • Garry Welch, Baystate Medical Center/Tufts University
  • George W. Reed, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Preventive and Behavioral Medicine; Department of Medicine, Division of Cardiovascular Medicine; Department of Medicine, Division of Endocrinology; Department of Family Medicine and Community Health
Date
4-4-2011
Document Type
Article
Subjects
Diabetes Mellitus, Type 2; Health Literacy; Poverty; Self Care; Hispanic Americans
Abstract

OBJECTIVE:

To test whether a theory-based, literacy, and culturally tailored self-management intervention, Latinos en Control, improves glycemic control among low-income Latinos with type 2 diabetes.

RESEARCH DESIGN AND METHODS:

A total of 252 patients recruited from community health centers were randomized to the Latinos en Control intervention or to usual care. The primarily group-based intervention consisted of 12 weekly and 8 monthly sessions and targeted knowledge, attitudes, and self-management behaviors. The primary outcome was HbA(1c). Secondary outcomes included diet, physical activity, blood glucose self-monitoring, diabetes knowledge and self-efficacy, and other physiological factors (e.g., lipids, blood pressure, and weight). Measures were collected at baseline and at 4- and 12-month follow-up. Change in outcomes over time between the groups and the association between HbA(1c) and possible mediators were estimated using mixed-effects models and an intention-to-treat approach.

RESULTS:

A significant difference in HbA(1c) change between the groups was observed at 4 months (intervention -0.88 [-1.15 to -0.60] versus control -0.35 [-0.62 to 0.07], P < 0.01), although this difference decreased and lost statistical significance at 12 months (intervention -0.46 [-0.77 to -0.13] versus control -0.20 [-0.53 to 0.13], P = 0.293). The intervention resulted in significant change differences in diabetes knowledge at 12 months (P = 0.001), self-efficacy (P = 0.001), blood glucose self-monitoring (P = 0.02), and diet, including dietary quality (P = 0.01), kilocalories consumed (P < 0.001), percentage of fat (P = 0.003), and percentage of saturated fat (P = 0.04). These changes were in turn significantly associated with HbA(1c) change at 12 months.

CONCLUSIONS:

Literacy-sensitive, culturally tailored interventions can improve diabetes control among low-income Latinos; however, strategies to sustain improvements are needed.

Comments

Citation: Diabetes Care. 2011 Apr;34(4):838-44. Epub 2011 Mar 4. DOI:10.2337/dc10-1981. Link to article on publisher's site

Related Resources
Link to article in PubMed
Keywords
  • UMCCTS funding
PubMed ID
21378213
Citation Information
Milagros C. Rosal, Ira S. Ockene, Angela Restrepo, Mary Jo White, et al.. "Randomized trial of a literacy-sensitive, culturally tailored diabetes self-management intervention for low-income latinos: latinos en control" Vol. 34 Iss. 4 (2011)
Available at: http://works.bepress.com/jeffrey-scavron/1/