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Diabetes Educ ; 39(6): 761-71, 2013.
Article in English | MEDLINE | ID: mdl-24052204

ABSTRACT

PURPOSE: The purpose of this article is to answer key implementation questions from our translation research with a primary care-based, nurse-community health worker (CHW) team intervention to support type 2 diabetes self-management. METHODS: Descriptive data are given on intervention delivery, CHW visit content, patient safety, and intervention costs, along with statistical analyses to examine participant characteristics of higher attendance at visits. RESULTS: In the intervention sample (n = 104), 74% (SD = 16%) of planned intervention visits occurred, guided by an algorithm-based protocol. Higher risk participants had a significantly lower dose of their weekly assigned visits (66%) than those at moderate (74%) and lower risk (90%). Twenty-eight percent of participants moved to a lower risk group over the year. Estimated intervention cost was $656 per person. Participants with less education were more likely to attend optimal percentage of visits. CONCLUSIONS: A nurse-CHW team can deliver a culturally adapted diabetes self-management support intervention with excellent fidelity to the algorithm-based protocols. The team accommodated participants' needs by meeting them whenever and wherever they could. This study provides an example of adaptation of an evidence-based model to the Samoan cultural context and its resource-poor setting.


Subject(s)
Community Health Workers/organization & administration , Diabetes Mellitus, Type 2/prevention & control , Diet , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Sedentary Behavior , Urbanization , Adult , Algorithms , American Samoa/epidemiology , Analysis of Variance , Blood Glucose/metabolism , Community Health Services/organization & administration , Community-Based Participatory Research , Cost-Benefit Analysis , Culture , Diabetes Mellitus, Type 2/ethnology , Diet/statistics & numerical data , Diet/trends , Female , Glycated Hemoglobin/metabolism , Health Education/organization & administration , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Referral and Consultation/statistics & numerical data , Self Care , Socioeconomic Factors , Urbanization/trends
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