259372 Effects of home-based diabetes symptom self-management education for Mexican Americans

Monday, October 29, 2012

Alexandra A. Garcia, PhD, RN, APRN-BC , School of Nursing, The University of Texas at Austin, Austin, TX
Sharon A. Brown, PhD, RN, FAAN , School of Nursing, The University of Texas at Austin, Austin, TX
Sharon Horner, PhD, RN, FAAN , School of Nursing, The University of Texas at Austin, Austin, TX
Kristopher L. Arheart, EdD , Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine - NIOSH Research Group, Miami, FL
Jule Zuņiga, MS, RN , School of Nursing, The University of Texas at Austin, Austin, TX
Raquel Reynolds, MS, RN , School of Nursing, The University of Texas at Austin, Austin, TX
Background: Patients need assistance interpreting and managing their symptoms, which are culturally-bound, often annoying, and potentially life-threatening. Diabetes care standards address some symptoms at diagnosis but fail to guide patients in day-to-day symptom management. This presentation reports the effect of an innovative home-based diabetes symptom awareness and self-management educational and case-management program for Mexican Americans, part of the fastest growing minority populations in the US and who are embattling a diabetes epidemic.

Methods: A repeated measures randomized controlled trial was conducted with 72 Mexican American adults aged 25-75 with type 2 diabetes. Participants in the experimental condition received 8 weekly in-home interactive, tailored, one-on-one educational and behavior modification sessions with an RN focusing on symptom awareness, glucose self-testing, and appropriate treatments followed by 8 biweekly support telephone sessions. Participants in the wait-listed control condition served as a comparison at three time points and then received the home-based portion of the intervention. Hierarchical linear modeling was used to evaluate the effects of the intervention between groups and within groups on diabetes knowledge, symptoms, psychosocial, behavioral, and clinical outcomes.

Results/Conclusions: Participants were predominantly female (67%) and middle aged (mean 50 years, SD 9). Over half (54%) were English-speaking. Those in the experimental group (n=39) showed significant improvements in diastolic BP, LDL cholesterol, diabetes knowledge, readiness to change behaviors, self-efficacy, empowerment, and quality of life. These findings and lessons learned in administering the RN-led home-based intervention inform a proposal for a larger version of the study that will test efficacy and cost-effectiveness.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Public health or related nursing

Learning Objectives:
1) Describe the culturally-specific home-based diabetes symptom self-management education intervention for adult Mexican Americans with type 2 diabetes. 2) Explain the findings for the intervention indicators of effectiveness.

Keywords: Diabetes, Latino

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator of the research being presented. I have been PI of funded studies in the area of Mexican Americans' diabetes self-management and diabetes symptoms for approximately 15 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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