Contemporary Clinical Trials Communications (Sep 2021)

Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands

  • Jennifer A. Andersen,
  • Holly Felix,
  • James Selig,
  • Brett Rowland,
  • Wana Bing,
  • Jonell Hudson,
  • Jack Niedenthal,
  • Henry Otuafi,
  • Sheldon Riklon,
  • Edlen Azures,
  • Ainrik George,
  • Pearl A. McElfish

Journal volume & issue
Vol. 23
p. 100824

Abstract

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Background: The Republic of the Marshall Islands (RMI) faces numerous health disparities, including one of the highest prevalence of type 2 diabetes mellitus (T2DM) in the world. Diabetes self-management education and support (DSMES) has shown efficacy in improving glycemic control and through increases in knowledge and self-management activities; however, there is limited research on DSMES in the RMI. This study evaluated the feasibility and efficacy of a culturally adapted family model of DSMES (F-DSMES) in the RMI. The F-DSME included 8 h of group educational classes delivered in churches by a community health worker. Methods: This pilot study assessed retention and dosage rates (e.g., class attendance) among the participants with T2DM (n = 41). Efficacy was evaluated by examining pre- and post-intervention differences in HbA1c, knowledge, family support, and self-management activities among those who completed the post-intervention data collection (n = 23). Results: The results indicate completion of post-intervention data collection and attendance were associated; 70% of participants who completed the post-intervention data collection received at least 6 h of intervention compared to 3 h for those who did not. Although the reduction in HbA1c was not statistically significant, participants demonstrated statically significant increases in knowledge, family support, and an increase in self-management including in checking of blood glucose and feet. Conclusions: This study provides important information to help address T2DM disparities in the RMI, including the feasibility and efficacy of F-DSMES. Additional research will help in understanding how to translate improvements in knowledge, family support, and self-management activities into improvements in HbA1c. This may include addressing social ecological factors that affect glycemic control.

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