OBJECTIVE -To determine the effects of a culturally competent diabetes self-management intervention in Mexican Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS-A prospective, randomized, repeated measures study was conducted on the Texas-Mexico border in Starr County. A total of 256 randomly selected individuals with type 2 diabetes between 35 and 70 years of age, diagnosed with type 2 diabetes after 35 years of age, and accompanied by a family member or friend were included. The intervention consisted of 52 contact hours over 12 months and was provided by bilingual Mexican American nurses, dietitians, and community workers. The intervention involved 3 months of weekly instructional sessions on nutrition, self-monitoring of blood glucose, exercise, and other self-care topics and 6 months of biweekly support group sessions to promote behavior changes. The approach was culturally competent in terms of language, diet, social emphasis, family participation, and incorporation of cultural health beliefs. Outcomes included indicators of metabolic control (HbA 1c and fasting blood glucose), diabetes knowledge, and diabetesrelated health beliefs.

The Starr County Diabetes Education StudyDevelopment of the Spanish-language diabetes knowledge questionnaire OBJECTIVE -This study reports the psychometric properties of the 24-item version of the Diabetes Knowledge Questionnaire (DKQ). RESEARCH DESIGN AND METHODS -The original 60-item DKQ was administered to 502 adult Mexican-Americans with type 2 diabetes who are part of the Starr County Diabetes Education Study. The sample was composed of 252 participants and 250 support partners. The subjects were randomly assigned to the educational and social support intervention (n = 250) or to the wait-listed control group (n = 252). A shortened 24-item version of the DKQ was derived from the original instrument after data collection was completed. Reliability was assessed by means of Cronbach' s coefficient ␣. To determine validity, differentiation between the experimental and control groups was conducted at baseline and after the educational portion of the intervention.RESULTS -The 24-item version of the DKQ (DKQ-24) attained a reliability coefficient of 0.78, indicating internal consistency, and showed sensitivity to the intervention, suggesting construct validation.CONCLUSIONS -The DKQ-24 is a reliable and valid measure of diabetes-related knowledge that is relatively easy to administer to either English or Spanish speakers.

OBJECTIVE -The objective of this study was to compare two diabetes self-management interventions designed for Mexican Americans: "extended" (24 h of education, 28 h of support groups) and "compressed" (16 h of education, 6 h of support groups). Both interventions were culturally competent regarding language, diet, social emphasis, family participation, and incorporating cultural beliefs.RESEARCH DESIGN AND METHODS -We recruited 216 persons between 35 and 70 years of age diagnosed with type 2 diabetes Ն1 year. Intervention groups of eight participants and eight support persons were randomly assigned to the compressed or extended conditions. The interventions differed in total number of contact hours over the yearlong intervention period, with the major difference being the number of support group sessions held. The same information provided in the educational sessions of the extended intervention was compressed into fewer sessions, thus providing more information during each group meeting.RESULTS -The interventions were not statistically different in reducing HbA 1c ; however, both were effective. A "dosage effect" of attendance was detected with the largest HbA 1c reductions achieved by those who attended more of the extended intervention. For individuals who attended Ն50% of the intervention, baseline to 12-month HbA 1c change was Ϫ0.6 percentage points for the compressed group and Ϫ1.7 percentage points for the extended group.CONCLUSIONS -Both culturally competent diabetes self-management education interventions were effective in promoting improved metabolic control and diabetes knowledge. A dosage effect was evident; attending more sessions resulted in greater improvements in metabolic control. Diabetes Care 28:527-532, 2005T wenty-one percent of the U.S. population lives in states bordering Mexico, and Ͼ33% of these individuals live in medically underserved border communities characterized by extreme poverty, pollution, deprivation, poor health, and diminished quality of life (1). Sixty percent of Hispanics, predominantly Mexican Americans who have the lowest rates of insurance coverage of any group, live in border states (2), and diabetes and related morbidity and mortality rates are highest among these border residents (3-6).Traditional approaches to managing diabetes in the U.S. have been perceived by Mexican Americans, in some instances, as culturally insensitive and, thus, have been ineffective (7). We designed and tested nonpharmacological, culturally competent, community-based diabetes self-management interventions in Starr County, a Texas-Mexico border community in which 98% of the residents are Mexican American (8). Promoting attendance at lifestyle programs, i.e., ensuring an adequate "dosage" of the intervention, is a challenge, particularly in underserved groups who may lack transportation and who tend to live chaotic lives, with frequent financial, health, and personal crises. Mexican Americans value social networks, and women are expected to provide health care for family, relatives, and friend...

This study investigated the effects of computer-assisted comprehension practice using a researcher-developed computer program, Computer-Assisted Collaborative Strategic Reading (CACSR), with students who had disabilities. Two reading/ language arts teachers and their 34 students with disabilities participated. Students in the intervention group received the CACSR intervention, which consisted of 50-min instructional sessions twice per week over 10 to 12 weeks. The results revealed a statistically significant difference between intervention and comparison groups' reading comprehension ability as measured by a researcher-developed, proximal measure (i.e., finding main ideas and question generation) and a distal, standardized measure (i.e., Woodcock Reading Mastery Test, Passage Comprehension). Effect sizes for all dependent measures favored the CACSR group. Furthermore, a majority of students expressed positive overall perspectives of the CACSR intervention and believed that their reading had improved.

The effects of three grouping formats—1:1 (one teacher with 1 student), 1:3 (one teacher with 3 students), and 1:10 (one teacher with 10 students)—on the reading outcomes of second-grade struggling readers was studied. Students in all groups were given the same supplemental reading intervention for the same number of sessions, thus holding intervention type and intensity constant and varying group size. Students made significant gains in phoneme segmentation, fluency, and comprehension following the intervention, and these gains were maintained at follow-up (4—5 weeks after intervention). Based on effect sizes, both 1:1 and 1:3 were highly effective intervention group sizes for supplemental reading instruction. Although the 1:1 grouping format yielded significantly higher scores for phoneme segmentation, fluency, and comprehension than the 1:10, it was not superior to the 1:3 on any outcome measure.

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Eight third-grade teachers and their 111 students participated in this 12-week study that was conducted within regular classroom settings. Sixteen of the students demonstrated significant reading problems and qualified for special education or were identified by the school district as dyslexic. This study addressed the differential effects of fluency and comprehension instruction on fluency and comprehension outcomes in two groups of students: those with significant reading problems and those who are low- to average-achieving students. Eight classrooms of third graders and their teachers were assigned to one of two interventions : partner reading, designed to enhance fluency, or collaborative strategic reading, designed to enhance comprehension. Results indicated no statistically significant main effects or group-by-time interaction effects; however, over time (pre- to posttest), there were statistically significant effects for rate of reading and correct words read per minute (but not accuracy or comprehension) for both partner reading and collaborative strategic reading for both low- to average-achieving students and students with reading disabilities.

This study addressed how learning disabled students prior to identification (LDPI), low-achieving (LA), average-achieving (AA), and high-achieving (HA) students compare on peer, teacher, and self assessments of social status and social skills in the fall and spring of kindergarten. Two hundred thirty-nine Black, Hispanic, and White students, 78% of a kindergarten population, participated. Controlling for age, sex, and achievement levels, four groups were identified: LDPI, LA, AA, and HA. In fall and spring of kindergarten all students were administered measures of peers' perceptions of social status, teacher's assessment of behavior problems and social skills, and self-perception, MANOVA and a stepwise discriminant function analysis revealed that as early as 8 weeks after entering kindergarten, LDPI students differed significantly from their peers on social variables and attention problems. Results suggest that later social difficulties of LD students are not solely a function of a history of low achievement and low teacher acceptance.