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A profile of Latinos with poorly controlled diabetes in South Florida | Kenya

The threefold purpose of this study is to assess diabetes knowledge among Hispanic/Latinos attending a culturally sensitive, empowerment-based, diabetes self-management education program; second, to examine the utility of the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) scale as an assessment tool for this population; and third, to assess the relationship between hemoglobin A1C and knowledge improvement in the intervention group. Latinos suffer from a higher prevalence of diabetic complications and mortality than whites yet receive less monitoring tests and education. Glycemic index and load were analyzed using data from three 24-hour dietary recalls conducted at baseline, 4 months, and 12 months. Patients attending outpatient clinics were interviewed by bilingual interviewers. The State of Idaho is a case in point. Those who spoke English very well (OR=2.32, 95% CI, 1.00-5.41) or not at all (OR=4.11, 95% CI 1.35-12.54) had higher odds of having an elevated HbA1c than those who spoke English well, although this was only statistically significant for those who spoke no English. Suarez also said that the level of education is a prime factor so that Latinos may be able to understand the disease, what factors put them at risk and preventative measures they can take.

Data on socio-demographic characteristics and additional determinants of health such as depression status, provider communication, diet, exercise, cigarette smoking, readiness to change diabetes management behaviors (stages of change), and confidence in ability to improve diabetes self-care (self-efficacy) were collected. We conclude that ancestry-directed search for genetic markers associated with type 2 diabetes in Latinos may benefit from information involving social factors, as these factors have a quantitatively important effect on type 2 diabetes risk relative to ancestry effects. We therefore sought to study the relationship between adiponectin, insulin sensitivity, and DR in type 2 diabetes. Longitudinal multivariate acculturation research is essential to disentangle these relations and to develop sound behavioral change theories that adequately predict behavioral change among Latinos. Andros said he opened his center, which takes an interdisciplinary approach, five years ago to deal with the No. Conclusion: In a diverse population of Latinos with poorly controlled diabetes in Miami, we found high rates of depression, obesity, medication non-adherence, poor self-efficacy, and provider communication. Remember that children are developing Type 2 Diabetes at a much younger age these days; sometimes as early as 5 years old!

Journal of Community Hospital Internal Medicine Perspectives 2015. © 2015 Sonjia Kenya et al. A program out of Brown University called Food on the Move brings a mobile farmers market to underserved communities. New interventions could improve weight control and the flow of diabetes information in family systems to reach males more effectively. . The IMPACT model was made more flexible with regard to responding to cultural norms and beliefs, low literacy, socioeconomic barriers, and social stigma. Recent data from the Hispanic Community Health Study found that more than 70% of Hispanics aged 45 years and older have diabetes or pre-diabetes (3).

Diabetes was defined according to American Diabetes Association guidelines [20] as an HbA1c0 ≥6.5 %, post-oral glucose tolerance test glucose ≥200 mg/dL, fasting glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, or self-reported use of anti-diabetic medication. In addition, with a rapid influx of Central and South Americans, South Florida is also rapidly becoming one of the most diverse Latino populations in the country (5, 6). Previous studies have shown that obesity rates among immigrants increase as their duration of residence in the U.S. We describe baseline characteristics of 300 Latino adults who were enrolled in a randomized study and provide data on physiologic measures, as well as socio-demographic, behavioral, and diabetes-specific constructs. The Miami Healthy Heart Initiative (MHHI) is a National Institutes of Health/National Heart, Lung and Blood Institute–sponsored randomized clinical trial (R01 HL083857) examining the impact of a 1-year community health worker (CHW)–led intervention on glycemic control, blood pressure, and cholesterol levels among 300 Latinos with poorly controlled diabetes. Hopefully as Every Little Step Counts progresses, they will be able to drastically reduce the number of families that are being affected by type 2 diabetes, and other universities will begin to take steps towards creating their own program. In brief, all participants were recruited from the primary care clinics of Jackson Health System which is in the Miami-Dade County public hospital system.

Participants were identified by review of electronic health records and some by provider referral. Inclusion criteria included being between the ages of 30 and 60, having had diabetes for at least 6 months, and having their last hemoglobin A1c (HbA1c) done within the past year and being ≥8 indicating poor glycemic control. 2000. Adherence to medication Morisky Medication Adherence Scale (15) This 8-item scale addresses adherence issues like forgetfulness or discontinuing medication because it makes patients feel better or worse. Response categories are yes/no for each item with a dichotomous response. Behavioral change Stages of Change (16) Participants’ response placed them in one of the following categories: precontemplation, contemplation, preparation, action, or maintenance. Diabetes self-efficacy The Diabetes Distress Scale (17) This 2-item scale measures two potential problem areas for people living with diabetes.

The items are on a 6 point gradient scale. Provider communication Medical Care Scale from the Stanford Patient Education Center (18) The scale consists of three measures with responses on a five-point gradient scale. Scale items address preparation for clinic appointments and discussions of confusion and personal problems related to patient’s illness. Upon completion of these assessments, participants were randomized to a control or intervention group. Culturally relevant diabetes education materials were sent monthly to control group participants. Intervention group participants received 12 months of personalized support from a Latino CHW, who provided individualized diabetes management education, accompaniment to medical and social service appointments, and linkages to other relevant healthcare resources. The health-promoting lifestyle composite summarizes all of the items on the questionnaire.

Physiologic and questionnaire data were entered into a password protected Excel database. Data entry was reviewed for accuracy by a separate research assistant and exported into SPSS software, prior to analysis. Characteristics of the population involving categorical variables were examined using frequencies. Means and standard deviations were calculated for continuous variables. The study was approved by the University of Miami Institutional Review Board and is registered in clinical trials.gov (NCT01152957). The 300 Latino participants represented diverse Hispanic ethnicities. Persons born in Cuba made up approximately 38% of our sample and the rest came from a large variety of regions of Latin America, including at least 10 persons born in Nicaragua, Colombia, Dominican Republic, Puerto Rico, Peru, and the mainland United States.

The others were from a large variety of countries, including Puerto Rico, Mexico, Dominican Republic, Ecuador, Columbia, Guatemala, Peru, Brazil, Argentina, Venezuela, and Honduras. Most participants (80%) had been living in the US for more than 10 years. With respect to race, four-fifths self-identified themselves as White (81%); 16% indicated their race was either ‘moreno’, ‘mixto’, ‘indigeno’, or another variation; and 3% identified their race as Black (Table 2). Acculturation level, the process of adapting to a new culture, was assessed using the Marin Short Acculturation Scale (MSAS) (10), which primarily focuses on the linguistic components of acculturation. The MSAS has six questions using a Likert scale and respondents can have a total acculturation score ranging from 6 to 30. The total acculturation score was calculated for each participant. Then, based on frequency distributions, we grouped respondents into acculturation tertiles to indicate minimal acculturation, low acculturation, or moderate acculturation.

The lowest possible score was 6, and participants who met that criteria were categorized as minimally acculturated. Acculturation status among those who scored between 7 and 10 was categorized as low, and those who scored between 11 and 30 met the criteria for moderate. Most of the sample scored minimal on acculturation with 48% achieving the lowest score possible and less than a quarter meeting the criteria for moderate acculturation. However, nearly 60% had completed at least 12 years of schooling (usually in their home country). Health literacy, which was measured using the Spanish version of the Short Assessment of Health Literacy Spanish and English (SAHL S&E), was relatively high with 85% having adequate health literacy, an understanding of common medical terminology.

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