Building a Healthy Temple: a Diabetes Self-management Support Program in Hispanic Faith Community Settings
tiistai 30. huhtikuuta 2019 päivittänyt: Dr. Meizi He, The University of Texas at San Antonio
The present study proposes to test the effectiveness of the Building a Healthy Temple: Diabetes Self-Management Support Program (BHT DSMS), a rendition of the Stanford DSMP in a spiritual context for the Hispanic faith community members.
Using a holistic approach through integrating spiritual and physical health, BHT translates the Stanford DSMP in a way that may result in lasting behavior changes and improved diabetes outcomes for Hispanics with type 2 diabetes (T2D).
Tutkimuksen yleiskatsaus
Tila
Tuntematon
Interventio / Hoito
Yksityiskohtainen kuvaus
The present study is proposing a 12-month translational study BHT DSMS to test the effectiveness of adapted Stanford DSMP in a spiritual context.
A cluster randomized trial with repeated measures will be conducted to compare the effectiveness of DSMS intervention strategies among 360 adult diabetic congregants from 18 predominantly Hispanic churches in San Antonio, Texas (20 participants/church). Using cluster randomized trial design; nine churches will be randomly assigned to the Faith-Based (FB) intervention, and nine to the Faith-Placed (FP) intervention.
The study will be implemented in two cohorts (8 churches for cohort 1 & 10 churches for cohort 2).
All intervention activities will be implemented over 14 consecutive weeks.
Participants in the FB group will participate in BHT DSMS, which includes a Health Sermon, a 6-session Health Bible Study with cooking demonstrations, the Stanford DSMP and a Diabetes Resource Seminar delivered by two trained church lay leaders.
Participants in the FP group will first attend a 7-session community health and safety curriculum as a partial attention control intervention, followed by the Stanford DSMP and Diabetes Resource Seminar facilitated by the local public health department.
The primary outcome will be a change in HbA1c levels.
Secondary outcomes include: changes in body mass index (BMI), waist circumference (WC), quality of life, diabetes self-care behaviors, eating behavior and physical activity level.
Data will be collected at baseline, 6, 9, and 12-months during the study period.
The aims of present study are 1) To test feasibility of the Stanford DSMP in FP and FB settings through observation and documentation of the implementation process, in-depth interviews with program staff and focus groups with participants to identify facilitators and barriers of the intervention.
2) To translate Stanford DSMP in a spiritual context for Hispanic faith community members and compare the effectiveness of a FB versus FP approach in improving diabetes outcomes.
Opintotyyppi
Interventio
Ilmoittautuminen (Odotettu)
360
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskelupaikat
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Texas
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San Antonio, Texas, Yhdysvallat, 78249
- Rekrytointi
- Human Nutrition Lab, UTSA
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Ottaa yhteyttä:
- Meizi He, PhD
- Puhelinnumero: 210-458-5416
- Sähköposti: meizi.he@utsa.edu
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Ottaa yhteyttä:
- Christian Umana, B.Sc.
- Puhelinnumero: 210-458-7408
- Sähköposti: c.umana424@gmail.com
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Päätutkija:
- Meizi He, PhD
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Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
21 vuotta - 85 vuotta (Aikuinen, Vanhempi Aikuinen)
Hyväksyy terveitä vapaaehtoisia
Ei
Sukupuolet, jotka voivat opiskella
Kaikki
Kuvaus
Inclusion Criteria:
- Church eligibility: [Churches must be predominantly Hispanics (60%) with at least 20 adult congregants with T2D willing to participate in the study. The rationale for 20 diabetic voluntary participants per church is based on the Stanford requirement of 12-16 participants allowed per support group and with an anticipated 25% attrition.]
- Participants' eligibility: Participants will be adults age 21 and above that have been diagnosed with T2D.
Exclusion Criteria:
- Children, adults under 21 years of age, and pregnant women
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Tukevaa hoitoa
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Yksittäinen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Kokeellinen: Faith-Based (FB, BHT DSMS)
The BHT DSMD intervention strategies adapted Stanford DSMP in a spiritual context is used in this group.
Participants in the FB group will participate in BHT DSMS, which includes a Health Sermon, a 6-session Health Bible Study with cooking demonstrations, the Stanford DSMP and a Diabetes Resource Seminar delivered by two trained church lay leaders.
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BHT DSMS Intervention components include Health Sermon and a 6-session Health Bible Study with cooking demonstrations, followed by the Stanford DSMP and a Diabetes Resource Seminar.
All intervention activities are implemented by trained church lay leaders.
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Active Comparator: Faith-Placed (FP, Stanford DSMP)
The traditional Stanford DSMP is conducted in this control group.
Participants in the FP group will first attend a 7-session community health and safety curriculum as a partial attention control intervention, followed by the Stanford DSMP and Diabetes Resource Seminar facilitated by the local public health department.
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Standard Stanford DSMP delivered by health professional
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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The change in HbA1c
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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A finger-prick blood sample will be collected for HbA1c testing using Metrika A1cNowTM (Bayer Health Care).
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Waist circumference
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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waist circumference (WC) will measured in the horizontal plane midway between the lowest rib and the iliac crest.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Body Mass Index
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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Participants' body weight and height will be measured.
BMI will be calculated height and weight (kg/M2)
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Quality of Life (QoL)
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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Quality of life in present study will be measured using the Problem Areas in Diabetes (PAID) scale (Polonsky and Anderson, 1995).
The PAID measure of diabetes related emotional distress correlates with measures of related concepts such as depression, social support, health beliefs, and coping style, as well as predicts future blood glucose control of the patient.
Questionnaire scale scoring: Each question has 5 possible answers with a value from 0 to 4, with 0 representing "no problem" and 4 "a serious problem".
The scores are added up and multiplied by 1.25, generating a total score between 0 - 100.
Patients scoring 40 or higher may be at the level of "emotional burnout" and warrant special attention.
PAID scores in these patients may drop 10-15 points in response to
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Diabetes Self-care practices
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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The Revised Summary of Diabetes Self-Care Activities (SDSCA) (Toobert, Hampson, and Glasgow, 2000).
It is a 25-item self-report measure of the frequency of performing diabetes self-care tasks over the preceding 7 days.
The response is based on a seven-point Likert scale to answer the question phrased as "On how many of the last 7 days did you…?".
Higher overall scores reflect good diabetes self-care practice.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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The barriers to diabetes care.
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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The barriers to diabetes care are investigated using selected questions from the National Survey of People with Diabetes (Harris, McGee, and Andrews, 2007).
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Physical Activity (PA) level assessment
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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A 6-item Exercise Behaviors scale (Lorig et al 1996) measures total minutes per week of aerobic and nonaerobic exercise specifically over the past seven days.
The first question measures the amount of time that the participant stretched or engaged in any strengthening exercises.
The other five questions measures aerobic activity.
The options for the questions include none, less than 30 minutes per week, 30-60 minutes per week, 1-3 hours per week, and more than 3 hours per week.
The total aerobic and stretching and/or strengthening minutes were calculate by converting the "None" category to 0 minutes; "Less than 30 minutes/week" into 15 minutes; "30-60 minutes/week" into 45 minutes; "1-3 hours/week" into 120 minutes; and "More than 3 hours/week" into 180 minutes.(6)
The response to the first question was used to determine the amount of time for stretching/strengthening while questions 2 through 6 were summed together to determine the amount of aerobic time.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Occupational physical activity
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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Occupational physical activity also is evaluated using a single-item question recommended by Behavioral Risk Factor Surveillance System (BRFSS) which is designed to categorize occupational physical activity into three components: 1) mostly sitting and standing (inactivity and low-intensity activity); 2) mostly waling (moderate-intensity activity); or 3) mostly heavy labor (vigorous-intensity activity) (www.cdc.gov/brfss/;
Yore MM, Bowles HR, 2006)
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Muut tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Diabetes self-efficacy
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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Diabetes self-efficacy scale will assess participants' diabetes self-efficacy (Sarkar, Fisher and Schillinger, 2006).
It is an 8-item instrument assessing diabetic individual's self-management efficacy.
These items addressed diabetes-specific domains such as confidence in self-monitoring of blood glucose (SMBG), as well as general health domains such as confidence in ability to get medical attention and take care of health using 4-point Likert-scale with responses from "1 = not at all sure" to "4 = very sure."
For each item patients rated their confidence in their ability to perform a recommended self-care routine.
The overall self-efficacy score are transformed to a 100-point scale with a higher score representing greater self-efficacy.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Social support in a spiritual context
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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Social support in a religion context will be measured using the instrument by Olphen et al.(2003) that assess the frequency with which participants receive support from other church members by asking "How often do people in your church or place of worship help you out?
The answer options include "1= never; 2= hardly ever; 3= not too often; 4= fairly often and 5= very".
Higher scores indicate greater levels of level of support.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Social support for diabetes self-management
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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• Social support for self-management will be assessed using modified Social Support Scale for Self-care in Middle-aged patients with type II diabetes (S4-MAD) (Naderimagham S, Niknami S, 2012) The questions in S4-MAD will be re-classified to evaluate the social support in emotional and information support, tangible support, affectionate support, positive support and additional support (www.rand.org).
The social support resources include "Are you attending worship service at this church?",
"Who help you the most in caring for your diabetes outside of church?", "Who helps you the most I caring for your diabetes within the church?".
The responses will be "1 = Never; 2 = Rarely; 3 = Sometimes; 4 = Often; 5 = Always".
The higher score reflects better spiritual coping.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Spiritual coping
Aikaikkuna: Data is collected at baseline, 6, 9, and 12-months during the study period.
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Spiritual coping in the DSMP context will be measured by adapting the RCOPE (Pargament, Koenig, and Perez) instrument particularly measuring spiritual coping strategies identified by diabetic individuals.
Areas include "I pray to and believe in God", "God keeps me alive", "I turn things over to God", "God changes my unhealthy behaviors", "God supplies my needs", "I read the Bible", and "I ask religious or spiritual individuals help me".
The responses will be "1 = Not at all; 2 = Somewhat; 3 = Quite a bit; 4 = A great deal".
The higher score reflects better spiritual coping.
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Data is collected at baseline, 6, 9, and 12-months during the study period.
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Yhteistyökumppanit ja tutkijat
Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.
Yhteistyökumppanit
Tutkijat
- Päätutkija: Meizi He, PhD, The University of Texas at San Antonio
Julkaisuja ja hyödyllisiä linkkejä
Tutkimusta koskevien tietojen syöttämisestä vastaava henkilö toimittaa nämä julkaisut vapaaehtoisesti. Nämä voivat koskea mitä tahansa tutkimukseen liittyvää.
Yleiset julkaisut
- Polonsky WH, Anderson BJ, Lohrer PA, Welch G, Jacobson AM, Aponte JE, Schwartz CE. Assessment of diabetes-related distress. Diabetes Care. 1995 Jun;18(6):754-60. doi: 10.2337/diacare.18.6.754.
- Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000 Jul;23(7):943-50. doi: 10.2337/diacare.23.7.943.
- Sarkar U, Fisher L, Schillinger D. Is self-efficacy associated with diabetes self-management across race/ethnicity and health literacy? Diabetes Care. 2006 Apr;29(4):823-9. doi: 10.2337/diacare.29.04.06.dc05-1615.
- van Olphen J, Schulz A, Israel B, Chatters L, Klem L, Parker E, Williams D. Religious involvement, social support, and health among African-American women on the east side of Detroit. J Gen Intern Med. 2003 Jul;18(7):549-57. doi: 10.1046/j.1525-1497.2003.21031.x.
- Naderimagham S, Niknami S, Abolhassani F, Hajizadeh E, Montazeri A. Development and psychometric properties of a new social support scale for self-care in middle-aged patients with type II diabetes (S4-MAD). BMC Public Health. 2012 Nov 28;12:1035. doi: 10.1186/1471-2458-12-1035.
- Harris J, McGee A, Andrews F, D'Souza J and Sproston K. The national survey of people with diabetes. Prepared for the Healthcare Commission Sept 2007.
- Lorig K. Outcome measures for health education and other health care interventions. Sage 1996.
- Yore MM, Bowles HR, Ainsworth BE, Macera CA, Kohl III HW. Single versus multiple item questions on occupational physical activity. Journal of Physical Activity and Health 3(1), 102-111, 2006
- Norris AE, Ford K, Bova CA. Psychometrics of a Brief Acculturation Scale for Hispanics in a probability sample of urban Hispanic adolescents and young adults. Hispanic Journal of Behavioral Sciences 18:29-38 (abstr), 1996
Hyödyllisiä linkkejä
- Occupational physical activity is evaluated using a single-item question recommended by Behavioral Risk Factor Surveillance System (BRFSS) .
- The questions in social support for self-management is re-classified to evaluate the social support in emotional and information support, tangible support, affectionate support, positive support and additional support.
Opintojen ennätyspäivät
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Opi tärkeimmät päivämäärät
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Ensimmäinen lähetetty
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Ensimmäinen toimitettu, joka täytti QC-kriteerit
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Ensimmäinen Lähetetty (Todellinen)
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Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Torstai 2. toukokuuta 2019
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Tiistai 30. huhtikuuta 2019
Viimeksi vahvistettu
Maanantai 1. huhtikuuta 2019
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Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- ADA#1-17-ICTS-029
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
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IPD-suunnitelman kuvaus
De-identified individual participant data for all primary and secondary outcome measures will be made available.
IPD-jaon aikakehys
Data will be available in December 2020.
IPD-jaon käyttöoikeuskriteerit
Data access requests will be reviewed by an external independent review panel.
Requestors will be required to sign a Data Access Agreement.
IPD-jakamista tukeva tietotyyppi
- Tutkimuspöytäkirja
- Tilastollinen analyysisuunnitelma (SAP)
- Ilmoitettu suostumuslomake (ICF)
- Kliinisen tutkimuksen raportti (CSR)
- Analyyttinen koodi
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