Improving behavioral and clinical indicators in older adults with diabetes: Findings from a community-clinic-based program

Background. More than 20% of older adults have diagnosed diabetes. To promote diabetes self-management behavior, a collaborative partnership among Kokua Kalihi Valley Comprehensive Family Services(KKV), the Hawaii State Department of Health, and the University of Hawaii adapted Stanford's 6-week Diabetes Self-Management Program (DSMP) to Hawaii's multicultural population. Purpose. This paper presents findings from testing the adapted DSMP in an immigrant elderly population (91% Filipino). Method. DSMP was tested using a one-group, pre-post-test design. We collected data on clinical measures (including BMI, blood pressure, blood cholesterol, blood glucose, and HbA1c), and health behaviors among DSMP participants at baseline and 6-months. Measurements will be tested 1 year follow-up at the end of the workshop. Results. Adaptations to DSMP were minimal, but critical to the local acceptance of the program. 101 participants (94 elders and 7 non-elders) enrolled, 101 (100%) completed the 6-week intervention, and 86 (85%) participated in 6-month data collection. At 6 months, significant behavioral improvements included: 1) increased minutes in stretch and aerobic exercises per week (p<.001); 2) reduced symptom of hypoglycemia and hyperglycemia (p<.001); 3) increased self-efficacy (p<.001); and 4) increased number of days and times to test blood sugar levels (p<.001). Significant clinical improvements included 1) lower BMI (p<.001); 2) lower HbA1c (p<.001); 3) lower total cholesterol (p<.001), triglyceride (p=.03), and LDL (p<.001); and 4) lower blood pressure (p<.001). Implications. Findings suggest that DSMP can be successfully adapted to this population and that participants can realize significant improvements in health.