141st APHA Annual Meeting

In This section

280312
Improving behavioral and clinical indicators in older adults with diabetes: Findings from a community-clinic-based program

Tuesday, November 5, 2013

Michiyo Tomioka, MS , Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI
Valerie Ah Cook, MPH , Diabetes Prevention and Control Program, Hawaii State Department of Health, Kapolei, HI
Kristin Wertin, MPH , Diabetes Prevention and Control Program, Hawaii State Department of Health, Kapolei, HI
Merlita Compton, MPH , Elder Services, Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
Kathryn L. Braun, DrPH , Office of Public Health Studies, University of Hawaii, Honolulu, HI
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.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture

Learning Objectives:
Discuss the importance of attending to cultural factors in implementing Stanford’s Diabetes Self-Management Program Describe the impact of Stanford’s Diabetes Self-Management Program for an immigrant elderly population Describe the successes and challenges of the evaluation of Stanford’s Diabetes Self-Management Program Identify key steps to adapting Stanford’s Diabetes Self-Management Program to a minority population and evaluating impact

Keywords: Evidence Based Practice, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved with a statewide healthy aging initiative and serving as an evaluator for more than seven years. During this time, I have provided leadership to the initiative members with project dissemination, through manuscripts and local and national conference presentations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.