| Title: |
Behavioral and technological interventions targeting glycemic control in a racially/ethnically diverse population: a randomized controlled trial |
| Authors: |
Forjuoh, Samuel N; Bolin, Jane N; Huber Jr, John C; Vuong, Ann M; Adepoju, Omolola E; Helduser, Janet W; Begaye, Dawn S; Robertson, Anne; Moudouni, Darcy M; Bonner, Timethia J; McLeroy, Kenneth R; Ory, Marcia G |
| Publisher Information: |
BioMed Central Ltd. |
| Publication Year: |
2014 |
| Collection: |
BioMed Central |
| Subject Terms: |
Chronic disease; Glycemic control; HbA1c; Self-management; Type 2 diabetes |
| Description: |
Background Diabetes self-care by patients has been shown to assist in the reduction of disease severity and associated medical costs. We compared the effectiveness of two different diabetes self-care interventions on glycemic control in a racially/ethnically diverse population. We also explored whether reductions in glycated hemoglobin (HbA1c) will be more marked in minority persons. Methods We conducted an open-label randomized controlled trial of 376 patients with type 2 diabetes aged ≥18 years and whose last measured HbA1c was ≥7.5% (≥58 mmol/mol). Participants were randomized to: 1) a Chronic Disease Self-Management Program (CDSMP; n = 101); 2) a diabetes self-care software on a personal digital assistant (PDA; n = 81); 3) a combination of interventions (CDSMP + PDA; n = 99); or 4) usual care (control; n = 95). Enrollment occurred January 2009-June 2011 at seven regional clinics of a university-affiliated multi-specialty group practice. The primary outcome was change in HbA1c from randomization to 12 months. Data were analyzed using a multilevel statistical model. Results Average baseline HbA1c in the CDSMP, PDA, CDSMP + PDA, and control arms were 9.4%, 9.3%, 9.2%, and 9.2%, respectively. HbA1c reductions at 12 months for the groups averaged 1.1%, 0.7%, 1.1%, and 0.7%, respectively and did not differ significantly from baseline based on the model ( P = .771). Besides the participants in the PDA group reporting eating more high-fat foods compared to their counterparts ( P < .004), no other significant differences were observed in participants’ diabetes self-care activities. Exploratory sub-analysis did not reveal any marked reductions in HbA1c for minority persons but rather modest reductions for all racial/ethnic groups. Conclusions Although behavioral and technological interventions can result in some modest improvements in glycemic control, these interventions did not fare significantly better than usual care in achieving glycemic control. More research is needed to understand how these ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://www.biomedcentral.com/1471-2458/14/71 |
| Availability: |
http://www.biomedcentral.com/1471-2458/14/71 |
| Rights: |
Copyright 2014 Forjuoh et al.; licensee BioMed Central Ltd. |
| Accession Number: |
edsbas.ED3D7631 |
| Database: |
BASE |