| Title | Controlled trial of nursing interventions to improve health outcomes of older african american women with type 2 diabetes. | | Author(s) | Skelly AH, Carlson J, Leeman J, Soward A, Burns D | | Institution | School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460, USA. askelly@email.unc.edu | | Source | Nurs Res 2009 Nov-Dec; 58(6):410-8. | | Abstract | BACKGROUND: Type 2 diabetes affects one in five African American women older than 60 years. These women face distinct challenges in managing diabetes self-care. Therefore, tailored self-care interventions for this population need to be developed and tested.
OBJECTIVES: The effectiveness of a tailored, four-visit, in-home symptom-focused diabetes intervention with and without booster telephone calls was compared with an attentional control focused on skills training for weight management and diet.
METHODS: African American women (n = 180; >55 years old, Type 2 diabetes mellitus >1 year, HbA1c >7%) were randomly assigned to the intervention or attentional control condition. Half the intervention participants were assigned to also receive a telephone-delivered booster intervention. Participants were evaluated at baseline and 3, 6, and 9 months.
RESULTS:: Baseline HbA1 was 8.3 in the intervention group (n = 60), 8.29 in the intervention with booster group (n = 55), and 8.44 in the attentional control condition (n = 59). HbA1c declined significantly in the whole sample (0.57%) with no differences between study arms. Participants in the booster arm decreased HbA1c by 0.76%. Symptom distress, perceived quality of life, impact of diabetes, and self-care activities also improved significantly for the whole sample with no significant differences between study arms.
DISCUSSION: Parsimonious interventions of four in-person visits yielded clinically significant decreases in HbA1c. Although the weight and diet program was intended as an attentional control, the positive effects suggest it met a need in this population. Because the contents of both the intervention and the attentional control were effective despite different approaches, a revised symptom-focused intervention that incorporates weight and diet skills training may offer even better results. | | Language | eng | | Pub Type(s) | Journal Article
Research Support, N.I.H., Extramural
| | PubMed ID | 19851122 |
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