Medical assistant coaching to support diabetes self-care among low-income racial/ethnic minority populations: randomized controlled trial

West J Nurs Res. 2014 Oct;36(9):1052-73. doi: 10.1177/0193945914522862. Epub 2014 Feb 25.

Abstract

Innovative, culturally tailored strategies are needed to extend diabetes education and support efforts in lower-resourced primary care practices serving racial/ethnic minority groups. A randomized controlled trial (RCT) examined the effect of a diabetes self-care coaching intervention delivered by medical assistants and the joint effect of intervention and ethnicity over time. The randomized repeated-measures design included 270 low-income African American and Hispanic/Latino patients with type 2 diabetes. The 1-year clinic- and telephone-based medical assistant coaching intervention was culturally tailored and guided by theoretical frameworks. A1C was obtained, and a self-care measure was completed at baseline, 6 months, and 12 months. Data were analyzed using mixed-effects models with and without adjustment for covariates. There was a significant overall improvement in mean self-care scores across time, but no intervention effect. Results revealed differences in self-care patterns across racial/ethnic subgroups. No differences were found for A1C levels across time or group.

Keywords: diabetes mellitus; health behavior; minority; self-management.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • African Americans / education*
  • African Americans / statistics & numerical data
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / therapy*
  • Hispanic Americans / education*
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Patient Education as Topic / methods*
  • Patient Education as Topic / standards
  • Poverty / statistics & numerical data*
  • Primary Health Care
  • Self Care / methods*
  • Self Care / standards
  • Telephone / statistics & numerical data