Long-Term Impact of a Community Health Worker Intervention on Diabetes Control in American Samoa.

Introduction: Diabetes Care in American Samoa (DCAS) was a randomized controlled trial of a 12-month intervention facilitated by community health workers (CHWs) that demonstrated improved HbA1c levels compared with usual care at trial completion. We sought to evaluate the long-term impact of this intervention on diabetes control.

Methods: We retrospectively collected HbA1c measurements from medical records of DCAS participants (n = 268).

Impact of a diabetes control and management intervention on health care utilization in American Samoa.

Objectives: To examine the impact of a successful 12-month behavioral intervention to improve diabetes control on health care utilization in American Samoa.

Methods: A cluster-randomized design was used to assign 268 diabetes patients to a nurse-community health worker intervention or usual care. Hospitalizations, emergency department, and primary care physician visits were collected retrospectively for 1 year prior to, and during, the intervention to assess changes in health care utilization.

Cultural translation of interventions: diabetes care in American Samoa.

Translation of research advances into clinical practice for at-risk communities is important to eliminate disease disparities. Adult type 2 diabetes prevalence in the US territory of American Samoa is 21.5%, but little intervention research has been carried out there.

Cancer prevention in primary care: predictors of patient counseling across four risk behaviors over 24 months.

Objective: Rates of preventive counseling remain below national guidelines. We explored physician and patient predictors of preventive counseling across multiple cancer risk behaviors in at-risk primary care patients.

Methods: We surveyed 3557 patients, with at least one of four cancer risk behaviors: smoking, diet, sun exposure, and/or mammography screening, at baseline and 24 months.

Providence school asthma partnership: school-based asthma program for inner-city families.

Over 3 years, 972 families participated in an after-school asthma program at their child's school. Parents and children attended concurrent 2(1/2)-hour workshops. Parents were 74% Latino; 45% non-English speaking, with 77% of children on Medicaid.

Assessment of parents' smoking behaviors at a pediatric emergency department.

The pediatric emergency department is an important source of treatment for children with complaints related to environmental tobacco smoke (ETS) and may provide a teachable moment to address parent smoking. Parents who smoke were recruited from a pediatric emergency department waiting room and completed an interview assessment used to develop intervention messages. Of the 715 parents in the final sample, 77% were women, 60% White, and 60% low income ( View Article and Find Full Text PDF

Assessing the transtheoretical model of change constructs for physicians counseling smokers.

Baseline data from a population-based sample of 259 primary care physicians were used to examine the interrelations of 3 central constructs of the Transtheoretical Model of Change (TTM; stages of change, self-efficacy, and decisional balance) in regard to smoking cessation counseling behavior. In this article we explore the potential use of the TTM for future interventions to help understand and guide physicians' behavior change toward increasing adoption of smoking cessation interventions with their patients. It was hypothesized that self-efficacy and the decisional balance of counseling would be significantly related to physicians' stages of change, which in turn would be related to self-reported physician counseling behavior.

Physician recruitment for a community-based smoking cessation intervention.

Objective: Our goal was to describe a strategy to recruit a population-based sample of physicians into a trial to test an approach to disseminate physician-delivered smoking cessation interventions.

Study Design: The 3-phase population-based recruitment trial included: (1) a print-based promotional appeal, (2) in-person presentations with by the principal investigator (PI), and (3) follow-up calls by the PI and paid physician recruiters. Participation requirements were kept minimal to facilitate recruitment.