Comparative Effectiveness of Peer Leaders and Community Health Workers in Diabetes Self-management Support: Results of a Randomized Controlled Trial

Diabetes Care: April 10, 2014

OBJECTIVE To compare a peer leader (PL) versus a community health worker (CHW) telephone outreach intervention in sustaining improvements in HbA1cover 12 months after a 6-month diabetes self-management education (DSME) program.

RESEARCH DESIGN AND METHODS One hundred and sixteen Latino adults with type 2 diabetes were recruited from a federally qualified health center and randomized to 1) a 6-month DSME program followed by 12 months of weekly group sessions delivered by PLs with telephone outreach to those unable to attend or 2) a 6-month DSME program followed by 12 months of monthly telephone outreach delivered by CHWs. The primary outcome was HbA1c. Secondary outcomes were cardiovascular disease risk factors, diabetes distress, and diabetes social support. Assessments were conducted at baseline, 6, 12, and 18 months. Read More

Understanding the High Prevalence of Diabetes in U.S. South Asians Compared with Four Racial/Ethnic Groups: The MASALA and MESA Studies

Diabetes Care: April 4, 2014

OBJECTIVE We compared South Asians with four other race/ethnic groups in the U.S. to determine whether sociodemographic, lifestyle, or metabolic factors could explain the higher diabetes prevalence, and whether insulin resistance and β-cell dysfunction occurred at younger ages and/or lower adiposity levels compared with other groups.

RESEARCH DESIGN AND METHODS Cross-sectional analysis of two community-based cohorts, the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study and the Multi-Ethnic Study of Atherosclerosis (MESA); all participants had no known cardiovascular disease and were between 44 and 84 years of age. We compared 799 South Asians with 2,611 whites, 1,879 African Americans, 1,493 Latinos, and 801 Chinese Americans. Read More

Needs and Concerns of Family Caregivers of Persons With Type 2 Diabetes An Integrated Review of Cross-cultural Literature With Implications for the American Indian Population

The Diabetes Educator: April 2, 2014

Purpose The purposes of this review were to identify the needs and concerns of family caregivers of persons with type 2 diabetes and to develop recommendations for future research on family caregivers of American Indians with type 2 diabetes. Searching the Cumulative Index to Nursing and Allied Health, Ovid, and PubMed, an extensive literature review was conducted using 10 search terms for articles published from 1990 to 2013. References of retrieved studies were also searched.

Conclusions On the basis of the search criteria, 6 studies exploring the needs and concerns of family caregivers of persons with type 2 diabetes were identified. Findings were placed in 5 predetermined categories derived from Bakas et al’s needs and concerns framework: (1) finding information and resources related to type 2 diabetes, (2) dealing with the emotions and behaviors of the care recipient, (3) providing physical care, (4) providing instrumental care, and (5) dealing with one’s own personal responses to caregiving. The cross-cultural literature helped identify common ground and specific literature about the experiences of American Indian caregivers.  Read more

Seven Generations: A Food Justice Lesson from Native Americans

Ebony: 2/26/14

Monifa Bandele on the Navajo Nation’s battle with junk food—and what we can learn from their efforts

This may be your story too. My great great great grandmother, Americos, was an enslaved Native American woman in North Carolina during the mid 1800s. Along with some of her African co-captives, she escaped bondage, traveled north, and settled in Rocky Mount, Virginia where she met and married one of my great grandfathers, Stephen Tyree. Eventually, they left the grips of the South, and our family’s post-slavery history began in Pittsburgh, Pennsylvania in the late 1800s. Their story was not unlike many stories of Native and African people living and struggling together in search of a better life, freedom, and justice.

For the most part, African Americans and Native Americans share a common history; forced captivity, relocation, and wholesale oppression. For centuries, that history has impacted our economic, political, and physical health and wellness. And for centuries, we have shared our experiences, strategies and solutions.  Read more

The association of depression and anxiety with glycemic control among Mexican Americans with diabetes living near the U.S.-Mexico border

BMC Public Health: February 18, 2014

Background

The prevalence of diabetes is alarmingly high among Mexican American adults residing near the U.S.-Mexico border. Depression is also common among Mexican Americans with diabetes, and may have a negative influence on diabetes management. Thus, the purpose of the current study was to evaluate the associations of depression and anxiety with the behavioral management of diabetes and glycemic control among Mexican American adults living near the border.

Methods

The characteristics of Mexican Americans with diabetes living in Brownsville, TX (N = 492) were compared by depression/anxiety status. Linear regression models were conducted to evaluate the associations of depression and anxiety with BMI, waist circumference, physical activity, fasting glucose, and glycated hemoglobin (HbA1c). Read more

The Mela Study: exploring barriers to diabetes research in black and minority ethnic groups

Cambridge: February 11, 2014

Background Black and minority ethnic (BME) groups are particularly susceptible to diabetes and its vascular complications in the United Kingdom and most western societies. To understand potential predisposition and tailor treatments accordingly, there is a real need to engage these groups in diabetes research. Despite this, BME participation in research studies continues to remain low in most countries and this may be a contributory factor to reduced health outcomes and poorer quality of life in these groups. This study explores the barriers BME groups may have towards participation in diabetes research in one area of East London, and includes local recommendations on how to improve this for the future.

Methods A questionnaire designed from previously reported exploratory work and piloted in several BME localities was distributed at the East London Bangladeshi Mela and similar cultural and religious events in London, UK. People were asked opportunistically to complete the survey themselves if they understood English, or discuss their responses with an advocate. The purpose of the questionnaire was to understand current local awareness with regards to diabetes, identify specific BME barriers and attitudes towards diabetes research by ethnicity, gender and age, and gain insight into how these barriers may be addressed. Read more

Genome-wide trans-ancestry meta-analysis provides insight into the genetic architecture of type 2 diabetes susceptibility

NATURE GENETICS:  February 9, 2014

To further understanding of the genetic basis of type 2 diabetes (T2D) susceptibility, we aggregated published meta-analyses of genome-wide association studies (GWAS), including 26,488 cases and 83,964 controls of European, east Asian, south Asian and Mexican and Mexican American ancestry. We observed a significant excess in the directional consistency of T2D risk alleles across ancestry groups, even at SNPs demonstrating only weak evidence of association. By following up the strongest signals of association from the trans-ethnic meta-analysis in an additional 21,491 cases and 55,647 controls of European ancestry, we identified seven new T2D susceptibility loci. Furthermore, we observed considerable improvements in the fine-mapping resolution of common variant association signals at several T2D susceptibility loci. Read more

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