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Improved Clinical Outcomes Using a Culturally Sensitive Diabetes Education Program in a Hispanic Population

From the Department of Epidemiology and Biostatistics in the School of Public Health (Mr Metghalchi, Ms Rivera, Dr Beeson), School of Medicine (Dr Firek), Center for Health Disparities and Molecular Medicine (Dr De Leon, Dr Cordero-MacIntyre), and Nutrition Department in the School of Public Health (Dr De Leon, Dr Cordero-MacIntyre), Loma Linda University, Loma Linda, California, and Department of Social and Behavioral Sciences, School of Public Health, University of North Texas, Fort Worth, Texas (Dr Balcazar).

Correspondence to Zaida R. Cordero-MacIntyre, PhD, Assistant Professor, Nutrition Department, School of Public Health, Loma Linda University, Loma Linda, CA 92350 (zcordero-macintyre{at}llu.edu).

Purpose

The purpose of this study was to evaluate the effects of a culturally sensitive diabetes education program for Hispanics with type 2 diabetes.

Methods

This study is a prospective cohort study to test the impact of a comprehensive diabetes education program on blood glucose control on Hispanics with type 2 diabetes. The educational program focused on maintaining glycemic control and general aspects of managing diabetes and complications. The study participants were recruited by flyers placed in Hispanic markets and in ambulatory care clinics. A total of 34 Hispanic male and female subjects with type 2 diabetes participated in the study. The concentrations of glucose, insulin, hemoglobin A1c (HbA1c), total cholesterol, triglycerides, low-density lipoprotein and high-density lipoprotein (HDL) cholesterol were analyzed at baseline and at 3 months.

Results

A significant mean change was observed for HbA1c, fasting plasma glucose, cholesterol/HDL ratio, and HDL after 3 months of education compared with baseline. There were significant reductions in weight, total fat, percent fat, trunk fat, and waist-to-hip ratio compared with baseline. After 3 months, subjects showed a significant positivecorrelation between changes in body mass index and insulin and weight, total fat, trunk fat, and fat free mass and insulin.

Conclusions

A culturally sensitive program conducted in Spanish had a significant impact on important clinical parameters in Hispanic subjects with diabetes in a relatively short time period. The study demonstrates the importance of designing education intervention studies that are sensitive to cultural diversity, particularly in at-risk diabetic subjects.

The Diabetes Educator, Vol. 34, No. 4, 698-706 (2008)
DOI: 10.1177/0145721708320913


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