326394
Adaptation and Implementation of a Stress Reduction Intervention with Tai Chi for Hispanic older adults with diabetes - Complete Results
Amparo Castillo, MD, PhD,
Midwest Latino Health Research, Training and Policy Center, University of Illinois at Chicago - Midwest Latino Health Research Training and Policy Center, Chicago, IL
Psychosocial stress negatively impacts glycemic control in persons with type 2 diabetes (T2D). Physical activity (PA) reduces stress but Hispanic older adults show low adherence to PA recommendations, and prefer low-impact exercise. Tai Chi (TC) is low-impact PA that has been associated with stress reduction and the prevention of diabetes-related complications. We adapted TC for stress reduction and glycemic control among Hispanic older adults with T2D. In phase 1, qualitative methods collected experiences of psychosocial stress, coping, physical activity, and acceptability of TC among Hispanic older adults with T2D; 27 seniors provided qualitative data to tailor a subsequent intervention. In phase 2, a randomized controlled trial (RCT) with crossover design compared TC to health education. TC classes were conducted twice a week for 12 weeks and outcome measures were assessed at baseline and posttest. Outcome measures included A1C, blood pressure, and psychosocial stress; covariates included PA self-efficacy, social support, medication adherence and quality of life. Separate data analyses were conducted for randomized groups, and for those receiving the intervention at any time. Forty participants (22 TC; 18 Control) entered the RCT. Results showed no significant differences between the two groups in any of the main outcomes. Separate pre-posttest analyses of those who received the intervention in the first and second rounds of TC (Non-RCT; N==41) showed significant reductions in A1C, diabetes distress, and immigration-related stress. Qualitative findings, issues to be considered in cultural adaptation of behavioral interventions, and differential results for RCT and non-RCT groups will be discussed.
Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Learning Objectives:
Describe cultural factors as stressors among Hispanic patients with diabetes;
List facilitating factors/obstacles in the adaptation of a behavioral intervention;
Identify potential limitations in the implementation of RCTs in community settings.
Keyword(s): Diabetes, Stress
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am the grant recipient, principal investigator, supervised intervention, data collection and analysis.
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.
