Publications by authors named "Ofeira Nu'usolia"

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).

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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.

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Article Synopsis
  • The article aims to address key implementation questions from a study involving a nurse-community health worker team that supports type 2 diabetes self-management.
  • Descriptive data covers intervention delivery, content of CHW visits, patient safety, intervention costs, and the attendance patterns among participants.
  • The findings show that 74% of planned visits were completed, with higher-risk participants attending fewer visits, and indicate that a culturally adapted approach can effectively support diabetes management in a resource-limited setting.
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The objective of this study is to describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Using data from prenatal clinic records, women (n = 692) were categorized according to the adequacy of prenatal care utilization index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way analysis of variance and independent samples t tests.

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In American Samoa (AS), nearly 22% of adults have type 2 diabetes. Diabetes is best managed by diet and lifestyle modifications and strict medication adherence. Cultural aspects might affect medication-taking beliefs, and thereby influence medication adherence.

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Article Synopsis
  • The study assessed a culturally tailored intervention involving nurses and community health workers (CHWs) aimed at improving diabetes self-management among Samoan individuals with type 2 diabetes.
  • Out of 268 participants, those in the nurse-CHW intervention experienced a significant reduction in HbA1c levels after 12 months, demonstrating better diabetes control compared to those receiving usual care.
  • Despite improvements in diabetes management, the intervention showed no significant differences in other health measures like blood pressure, weight, or waist circumference after a year.
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High Type 2 diabetes prevalence, associated with recent cultural changes in diet and physical activity, characterizes the U.S. territory of American Samoa.

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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.

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