Online Program

Improving behavioral and clinical indicators in older adults with diabetes: Findings from a community-clinic-based program

Tuesday, November 5, 2013

Michiyo Tomioka, PhD, Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI
Valerie Ah Cook, MPH, Diabetes Prevention and Control Program, Hawaii State Department of Health, Kapolei, HI
Kristin Wertin, MPH, Diabetes Prevention and Control Program, Hawaii State Department of Health, Kapolei, HI
Merlita Compton, MPH, Elder Services, Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
Kathryn L. Braun, DrPH, Office of Public Health Studies, University of Hawaii, Honolulu, HI
Background. More than 20% of older adults have diagnosed diabetes. To promote diabetes self-management behavior, a collaborative partnership among Kokua Kalihi Valley Comprehensive Family Services(KKV), the Hawaii State Department of Health, and the University of Hawaii adapted Stanford's 6-week Diabetes Self-Management Program (DSMP) to Hawaii's multicultural population. Purpose. This paper presents findings from testing the adapted DSMP in an immigrant elderly population (91% Filipino). Method. DSMP was tested using a one-group, pre-post-test design. We collected data on clinical measures (including BMI, blood pressure, blood cholesterol, blood glucose, and HbA1c), and health behaviors among DSMP participants at baseline and 6-months. Measurements will be tested 1 year follow-up at the end of the workshop. Results. Adaptations to DSMP were minimal, but critical to the local acceptance of the program. 101 participants (94 elders and 7 non-elders) enrolled, 101 (100%) completed the 6-week intervention, and 86 (85%) participated in 6-month data collection. At 6 months, significant behavioral improvements included: 1) increased minutes in stretch and aerobic exercises per week (p<.001); 2) reduced symptom of hypoglycemia and hyperglycemia (p<.001); 3) increased self-efficacy (p<.001); and 4) increased number of days and times to test blood sugar levels (p<.001). Significant clinical improvements included 1) lower BMI (p<.001); 2) lower HbA1c (p<.001); 3) lower total cholesterol (p<.001), triglyceride (p=.03), and LDL (p<.001); and 4) lower blood pressure (p<.001). Implications. Findings suggest that DSMP can be successfully adapted to this population and that participants can realize significant improvements in health.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture

Learning Objectives:
Discuss the importance of attending to cultural factors in implementing Stanford’s Diabetes Self-Management Program Describe the impact of Stanford’s Diabetes Self-Management Program for an immigrant elderly population Describe the successes and challenges of the evaluation of Stanford’s Diabetes Self-Management Program Identify key steps to adapting Stanford’s Diabetes Self-Management Program to a minority population and evaluating impact

Keyword(s): Evidence Based Practice, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved with a statewide healthy aging initiative and serving as an evaluator for more than seven years. During this time, I have provided leadership to the initiative members with project dissemination, through manuscripts and local and national conference presentations.
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.