ミシガン男性糖尿病プロジェクト 2 (MenD 2)

実験的：ピア主導の糖尿病自己管理サポート (PLDSMS)

PLDSMS 部門の参加者は、認定された糖尿病ケアおよび教育の専門家による 10 時間の糖尿病自己管理教育 (DSME) を受けます。 その後、このグループは、トレーニングを受けたピア リーダーによる月 1 回の 90 分間の糖尿病自己管理サポート (DSMS) に 6 か月間移行します。 DSMS セッションの後、グループは 6 か月間の継続的なサポートに移行し、彼らにとって重要なイニシアチブを通じて DSMS を継続することが奨励されます。

行動：ピア主導の糖尿病自己管理サポート

糖尿病関連の教育と短期間の臨床的、心理社会的、および行動的改善のためのサポートを提供するピア主導の介入の有効性は十分に確立されていますが、特に年配の黒人男性は参加する可能性が低く、脱落のリスクが高くなります。これらの研究から。 この介入は、年配の黒人男性を他の年配の黒人男性のピアリーダーとして使用することで、この集団の保持率が向上するかどうかを判断することを目的としています.

行動：糖尿病自己管理教育

参加者は、オンラインの HIPPA 準拠の Zoom プラットフォームを通じて、認定された糖尿病ケアおよび教育の専門家が指導する 10 時間の仮想グループ糖尿病自己管理教育クラスに参加します。

アクティブコンパレータ：対照群

対照群の参加者は、認定された糖尿病ケアおよび教育の専門家による 10 時間の糖尿病自己管理教育 (DSME) を受けます。

行動：糖尿病自己管理教育

参加者は、オンラインの HIPPA 準拠の Zoom プラットフォームを通じて、認定された糖尿病ケアおよび教育の専門家が指導する 10 時間の仮想グループ糖尿病自己管理教育クラスに参加します。

Hemoglobin A1c

Anthropometric data/clinical data - Change in HbA1c. HbA1c was measured using the DCA 2000 point-of-care testing instrument. A longitudinal mixed-effects linear regression model was used to examine changes in primary and secondary outcomes over time between the intervention (PLDSMS) and control (EUC) groups. The reference/comparison group was the PLDSMS group.

Change in Diabetes Self-Management

Psychosocial survey data collection (self-reported). Diabetes self-management was measured using the 8-item Perceived Diabetes Self-Management Scale (PDSMS), with summed scores ranging from 8 to 40 and higher scores representing greater self-effectiveness. A longitudinal mixed-effects linear regression model was used to examine changes in primary and secondary outcomes over time between the intervention (PLDSMS) and control (EUC) groups. The reference/comparison group was the PLDSMS group.

Change in BMI

Weight relative to height. A longitudinal mixed-effects linear regression model was used to examine changes in primary and secondary outcomes over time between the intervention (PLDSMS) and control (EUC) groups. The reference/comparison group was the PLDSMS group.

Change in Depression

Psychosocial survey data collection (self-reported). Patient Health Questionnaire (PHQ-9)

o Sum Scores: The total score categorizes depression severity:

• 0-4: Minimal or none
• 5-9: Mild
• 10-14: Moderate
• 15-19: Moderately severe
• 20-27: Severe

A longitudinal mixed-effects linear regression model was used to examine changes in primary and secondary outcomes over time between the intervention (PLDSMS) and control (EUC) groups. The reference/comparison group was the PLDSMS group.

Change in Blood Pressure (Systolic)

Anthropometric data/clinical data - Change in Blood Pressure (systolic - mmHg). Blood pressure was measured using an automated machine that obtained three readings with 1 min between each reading. The readings were averaged and recorded. A longitudinal mixed-effects linear regression model was used to examine changes in primary and secondary outcomes over time between the intervention (PLDSMS) and control (EUC) groups. The reference/comparison group was the PLDSMS group.

Change in Blood Pressure (Diastolic)

Anthropometric data/clinical data - Change in Blood Pressure (diastolic - mmHg). Blood pressure was measured using an automated machine that obtained three readings with 1 min between each reading. The readings were averaged and recorded. A longitudinal mixed-effects linear regression model was used to examine changes in primary and secondary outcomes over time between the intervention (PLDSMS) and control (EUC) groups. The reference/comparison group was the PLDSMS group.

Change in Diabetes Social Support

To measure perceived social support, the 8-item Social Support Questionnaire (Duke-UNC Functional Social Support Questionnaire) was used. Responses are measured on a Likert scale from 1 ("Much less than I would like") to 5 ("As much as I would like"). The higher the score, the higher the level of perceived support. In the current study, response options ranged from 1 ("Much less than I would like") to 6 ("As much as I would like") across all eight items. Responses to the eight items were summed to produce a total score ranging from 8 to 48. Higher total scores indicate greater perceived social support.

Change in Diabetes-Related Distress (Core)

To measure diabetes distress (emotional distress as a result of living with type 2 diabetes), the Type 2 Diabetes Distress Assessment System (T2-DDAS) was used. The Core Distress Score is the average of all eight items of the scale and is measured on a 1 to 5 Likert scale ("Not a Problem = 1" to "A Very Serious Problem = 5"). Higher scores indicate higher levels of distress. A mean score of <2.0 indicates little or no distress. A mean score ≥2.0 but not more than 2.9 indicates moderate distress. A mean score ≥3.0 indicates high distress. Any score >2.0 is considered clinically significant.

Change in Conformity to Masculine Norms

The Short Form of the Conformity to Masculine Norms Inventory (CMNI-30) was used to assess conformity to traditional masculine norms. Participants rated the extent to which they agreed with 30 behavioral statements. Each item was scored on a 6-point scale ranging from 0 (strongly disagree) to 5 (strongly agree). Responses to all 30 items were summed to calculate a total score ranging from 0 to 150. Higher total scores indicate stronger adherence to traditional masculine norms.