141st APHA Annual Meeting

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Effect of a bilingual diabetes education interactive telenovela on glycemic control among hispanic patients with type 2 diabetes: A randomized clinical trial

Wednesday, November 6, 2013 : 9:30 AM - 9:50 AM

Luis Rustveld, PhD, RD, LD , Family and Community Medicine, Baylor College of Medicine, Houston, TX
Susan Nash, PhD , Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
Carol Mansyur, PhD , School of Community & Environmental Health, Old Dominion University, Norfolk, VA
Maria Jibaja-Weiss, EdD , Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX
Background: Hispanic adults with T2DM exhibit lower glycemic control than other racial/ethnic groups. Optimal diabetes control requires adherence to multiple complex self-care behaviors. This study tested whether a culturally and linguistically appropriate interactive diabetes education program improved glycemic control, as measured by reduction in glycosylated hemoglobin A1c (HbA1c). Methods: Participants were Hispanic adults with poorly controlled T2DM (HbA1c ≥ 8.0) recruited from 4 community health clinics and randomized to intervention (n = 125) or usual care control (n = 125) group. Intervention patients viewed a diabetes interactive telenovela (DIT) incorporating key diabetes management strategies (diet, exercise, and medication). Psychosocial and selfcare measures were obtained at baseline and three months. Laboratory measures, including HbA1c, were abstracted from medical records. Results: Intervention patients exhibited significant HbA1c reduction (intervention mean = -1.4 0.20 vs. control mean = -0.7 0.19, p = 0.04). Further reduction in HbA1c was observed among patients with microvascular complications (intervention mean = -1.7 0.37 vs. control mean = -0.4 0.30, p = 0.01). There was greater reduction in HbA1c among women (women mean = -1.3 0.17 vs. men mean = -0.8 0.24). However, insulin therapy attenuated HbA1c reduction in women, but not in men (women mean = -0.7 0.22 vs. men mean = -0.9 0.29). Conclusion: Findings indicate that the DIT is an effective diabetes management tool for Hispanic patients. Diabetes education and counseling messages should consider gender differences in diabetes management and reinforce that insulin therapy is an effective control strategy.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
Describe the role of a culturally tailored diabetes interactive telenovela in improving glycemic control in Hispanic patients with T2DM. Discuss gender differences in diabetes management, particularly insulin therapy, and the impact on glycemic control in Hispanic patients.

Keywords: Diabetes, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm an epidemiologist and Assistant Professor in the Department of Family and Community Medicine at Baylor College of Medicine. I completed an NIH post-doctoral fellowship (National Research Service Award T32) in the same department. My research interests include interventions for the prevention and management of chronic diseases such as diabetes, obesity, cardiovascular disease, and cancer.I am project co-director for the Sugar, Heart, and Life diabetes education program, and Licensed Registered Dietitian at Baylor Family Medicine.
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.