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.

Strategies for implementing and sustaining therapeutic lifestyle changes as part of hypertension management in African Americans.

African Americans with high blood pressure (BP) can benefit greatly from therapeutic lifestyle changes (TLC) such as diet modification, physical activity, and weight management. However, they and their health care providers face many barriers in modifying health behaviors. A multidisciplinary panel synthesized the scientific data on TLC in African Americans for efficacy in improving BP control, barriers to behavioral change, and strategies to overcome those barriers.

Food availability, neighborhood socioeconomic status, and dietary patterns among blacks with type 2 diabetes mellitus.

Context: High diabetes prevalence among low-income and urban African American populations. OBJECTIVES & MAIN OUTCOME MEASURES: This study aimed to determine associations between neighborhood-level food sources and socioeconomic status (SES), and dietary patterns and body-mass index (BMI). The hypotheses were that the presence of food stores in neighborhoods would be associated with better dietary habits and BMI, and that the presence of convenience stores, and lower neighborhood SES, would be associated with poorer dietary habits and BMI.

Association between parental history of type 2 diabetes and glycemic control in urban African Americans.

Objective: The purpose of this study was to examine the association between parental history of type 2 diabetes and glycemic control among diabetic urban African Americans.

Research Design And Methods: Study participants included 359 African Americans with type 2 diabetes from Baltimore, Maryland, enrolled in Project Sugar 2. Participants underwent an interview-administrated questionnaire that asked about family history, sociodemographics, clinical characteristics, and knowledge and perception of adequate glycemic control.

Diabetes problem-solving scale development in an adult, African American sample.

Purpose: The purpose of this pilot study was to examine psychometric properties of the Diabetes Problem-Solving Scale (DPSS), which was designed to assess how adults with type 2 diabetes approach and manage problems encountered in diabetes self-management.

Methods: Participants were 64 African American adults with type 2 diabetes. The 30-item DPSS and measures of social problem solving, diabetes self-management, and depressive symptoms were administered.

Training community health workers as diabetes educators for urban African Americans: value added using participatory methods.

Background: With growing use of Community Health Workers (CHWs) to reach underserved populations, there is a need for more information on training methods to prepare CHWs, particularly in a health educator role.

Objectives: To describe procedures used to recruit, train, and evaluate CHWs in Project Sugar 2, a randomized controlled trial of a nurse case manager and CHW team intervention designed to improve diabetes care and control in a sample of 542 urban African Americans with type 2 diabetes.

Methods: CHWs received a Core Training on guidelines and procedures, didactic diabetes self-management education, and research protocol training.

Association of social problem solving with glycemic control in a sample of urban African Americans with type 2 diabetes.

The Social Problem-Solving Inventory--Revised, Short Form, was administered to 65 urban African Americans with type 2 diabetes to examine association of generic problem-solving styles and orientation with hemoglobin A1C (A1C). Eighty-five percent of participants had total social problem-solving scores in the Average range or higher. In linear regression models adjusted for education, each interquartile increase in impulsive/careless score was associated with a 0.

A systematic review of interactive computer-assisted technology in diabetes care. Interactive information technology in diabetes care.

Background: Excellent diabetes care and self-management depends heavily on the flow of timely, accurate information to patients and providers. Recent developments in information technology (IT) may, therefore, hold great promise.

Objective: To determine, in a systematic review, how emerging interactive IT has been used to enhance care for adults with type 2 diabetes.

Patient satisfaction, preventive services, and emergency room use among African-Americans with type 2 diabetes.

The aim of this study was to determine the relationship between patient satisfaction and diabetes- related preventive health care and emergency room (ER) use. We studied 542 urban African-Americans with type 2 diabetes aged > or =25 years who were enrolled in a primary carebased intervention trial to improve diabetes control and reduce adverse health events; 73% female, mean age 58 years, 35% had yearly household incomes of <$7500, and all participants had health insurance. All completed a baseline interview-administered questionnaire.

Translational research principles of an effectiveness trial for diabetes care in an urban African American population.

Purpose: Large-scale effectiveness trials designed to translate evidence-based diabetes care to community settings are few. Studies describing these methods among high-risk minority populations are particularly limited.

Methods: The authors describe Project Sugar, a randomized controlled trial conducted in 2 phases: Project Sugar 1 (1994-1999), which piloted a 4-arm clinic and home-based intervention using nurse case management and community health workers in 186 urban African Americans with type 2 diabetes, and Project Sugar 2 (2000-2005), which examined effectiveness of this intervention among 542 diabetic, urban African Americans.

Computer and internet use among urban African Americans with type 2 diabetes.

Previous studies have identified a "digital divide" between African Americans and whites, with African Americans having substantially lower rates of Internet use. However, use of the Internet to access health information has not been sufficiently evaluated in this population. Therefore, we conducted a telephone survey to determine the prevalence of computer and Internet use among 457 African American adults with type 2 diabetes.

A randomized controlled trial of the effects of nurse case manager and community health worker team interventions in urban African-Americans with type 2 diabetes.

The objective of the study was to determine the effectiveness and cost-effectiveness of primary care and community-oriented interventions in managing HbA1c, blood pressure, and lipids, and reducing hospitalizations and emergency room visits over 2 years. We describe an ongoing, randomized controlled trial of 542 urban African-Americans with type 2 diabetes ages 25 years and older who are members of a university-affiliated managed-care organization in Baltimore, MD. The participants are 74% female, have a mean age of 58 years, and 35% have yearly incomes greater than 7500 US dollars.