An automated telephone nutrition support system for Spanish-speaking patients with diabetes

J Diabetes Sci Technol. 2014 Nov;8(6):1115-20. doi: 10.1177/1932296814550186. Epub 2014 Sep 19.

Abstract

In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (-0.3% in the control arm, -0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland.

Keywords: Spanish; diabetes care; self-care; telephone nutrition support; vulnerable populations.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Automation
  • Counseling / methods
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diet Therapy / methods*
  • Female
  • Glycated Hemoglobin / analysis
  • Glycemic Index
  • Hispanic or Latino
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status*
  • Telemedicine / methods*
  • Telephone

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human