Diabetes self‐management education exposure and glycated haemoglobin levels among Marshallese participants in a randomized controlled study

McElfish, Pearl A.; Long, Christopher R.; Bursac, Zoran; Scott, Aaron J.; Felix, Holly C.; Schulz, Thomas; Worley, Mark A.; Rowland, Brett

doi:10.1111/dme.14189

Cited by 17 publications

(16 citation statements)

References 23 publications

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“…The team includes more than 20 Marshallese staff members working at the university and communitybased organizations, Marshallese nurses, and a Marshallese physician. It is led by a community advisory board and include subcontracts to several nonprofit organizations led by Marshallese people (44,47,49,50). The partnership was funded by a CDC program, Racial and Ethnic Approaches to Community Health (REACH).…”

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confidence: 99%

COVID-19 Disparities Among Marshallese Pacific Islanders

et al. 2021

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Rates of coronavirus disease 2019 (COVID-19) infections, hospitalizations, and deaths differ across racial and ethnic groups in the United States and disproportionately affect minority communities (1-6). In states reporting disaggregated data for Pacific Islander populations, rates of COVID-19 infections, hospitalizations, and deaths were significantly higher among Pacific Islanders than among the White population and other racial and ethnic minority populations (4,7,8). Because the disparities were so alarming among Marshallese Pacific Islanders in northwest Arkansas (ie, Benton and Washington counties), the Centers for Disease Control and Prevention (CDC) conducted a multi-week site visit in late June and early July 2020. Their July 2020 report details the disproportionate effect of COVID-19 on the Marshallese population in this region (9). Marshallese are estimated to make up just 1.5% to 3% of the total population of Benton and Washington counties, yet they accounted for 19% of all COVID-19 cases in the region (9). Of Marshallese patients with COVID-19 during March-June 2020, 9% were hospitalized (9). Nationally, CDC reported that 144.1 per 100,000 (<0.01%) of patients with COVID-19 were hospitalized as of June 2020. Most alarmingly, Marshallese people accounted for 38% of the reported deaths in the 2-county region during March-June 2020 (9). The Marshallese community in northwest Arkansas bears a much larger burden of COVID-19 infection, hospitalization, and death than other racial and ethnic minorities (2,9).

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confidence: 99%

COVID-19 Disparities Among Marshallese Pacific Islanders

et al. 2021

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“…Family members can monitor the behavior of patients' diabetes education course learning through the family portal, and the study by McElfish et al [19] has revealed that family-model diabetes self-management education shows better effects than standard diabetes self-management education [19]. The family-model can increase the time of exposure to diabetes self-management education, and increased time of exposure to leads to improved glycemic control in patients [20]. The diabetes education courses on the LCCP platform cover patients' self-care behaviors according to the American Association of Diabetes Educators 7 Standard of Care.…”

Section: Principal Findingsmentioning

confidence: 99%

“…Family member engagement in diabetes self-management education programs can improve patients' self-management behaviors, quality of life, and glycemic control [16][17][18]. Studies have also shown that family-model diabetes self-management education is superior to conventional diabetes education that only involves patients [19,20]. However, family members, especially young members, cannot always participate in diabetes management programs that require onsite visits for long periods of time [11].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of the Family Portal Function on the Lilly Connected Care Program (LCCP) for Patients With Type 2 Diabetes: Retrospective Cohort Study With Propensity Score Matching

Zhang¹,

Liu²,

Luo³

et al. 2021

JMIR Mhealth Uhealth

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Background Diabetes is a major health concern worldwide. Family member engagement in diabetes self-management education programs can improve patients’ diabetes management. However, there is limited evidence that the family portal on diabetes management apps is effective in the glycemic control of patients with diabetes. Objective We aimed to evaluate the effectiveness of family support through the family portal function on Lilly Connected Care Program (LCCP) platform. Methods This retrospective cohort study included patients with type 2 diabetes recruited to the LCCP platform from September 1, 2018, to August 31, 2019. Propensity score matching was used to match family (group A) and non–family (group B) portal use groups with similar baseline characteristics. The patients were followed up with for 12 weeks. The main objectives were differences in mean fasting blood glucose, proportion of patients achieving fasting blood glucose target <7mmol/L, mean postprandial blood glucose, proportion of patients achieving postprandial blood glucose target <10mmol/L, proportion of patients achieving both fasting blood glucose <7mmol/L and postprandial blood glucose <10mmol/L, self-monitoring of blood glucose frequency at week 12 and the number of diabetes education courses patients completed during the 12 weeks. Moreover, logistic regression analysis was used to explore the baseline factors which may be associated with the use of family portal, and odds ratios with 95% confidence intervals were calculated. Results A total of 6582 adult patients (aged ≥18 years) with type 2 diabetes who were receiving insulin therapy were enrolled in the study. Overall, 6.1% (402/6582) of the patients chose to engage their family members to use the family portal. Two groups of 394 patients were well-matched regarding baseline characteristics. After matching, mean fasting blood glucose and postprandial blood glucose at week 12 were significantly lower in group A than in group B (fasting blood glucose: 7.12 mmol/L, SD 1.70 vs 7.42 mmol/L, SD 1.88, respectively, P=.02; postprandial blood glucose: 8.56 mmol/L, SD 2.51 vs 9.10 mmol/L, SD 2.69, respectively, P=.002). When comparing group A to group B, the proportion of patients achieving both fasting blood glucose <7mmol and postprandial blood glucose <10mmol/L at week 12 (46.8% vs 39.4%, respectively, P=.04), self-monitoring of blood glucose frequency at week 12 (8.92 times per week, SD 6.77 vs 8.02 times per week, SD 5.97, respectively, P=.05) and number of diabetes education courses completed in 12 weeks (23.00, IQR9.00-38.00 vs 15.00, IQR 4.00-36.00, respectively, P<.001) was higher. Additionally, multivariate logistic regression analysis showed that higher age (OR=0.987, 95% CI 0.978-0.996, P=.006) and higher baseline fasting blood glucose (OR=0.914, 95% CI 0.859-0.972, P=.004) were correlated with less use of the family portal function, while increased baseline self-monitoring of blood glucose frequency (OR=1.022, 95% CI 1.012-1.032], P<.001) as well as increased education courses (OR=1.026, 95% CI 1.015-1.036, P<.001) were associated with more use of the family portal function. Conclusions Family support through the LCCP family portal is effective for glycemic control and self-management behavior improvement in type 2 diabetes patients.

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“…The intervention was delivered in primary participants' homes by a bilingual CHW with a certified diabetes educator (CDE) present. The F-DSMES demonstrated effectiveness compared with standard DSMES delivered by CDEs in a group setting [ 31 , 32 ]; however, the methods used in this previous trial may not be directly transferable to the RMI. The RMI lacks the resources to deliver standard DSMES effectively due to a lack of CDEs in the RMI.…”

Section: Introductionmentioning

confidence: 99%