Table 1—

Characteristics of the intervention

Baseline
Intervention

MeasuresWeekly education sessions (12 weekly meetings)Support group sessions (14 biweekly meetings)Postintervention at 3, 6, and 12 months
• Demographics (age, gender, age of diabetes diagnosis, etc.)• IntroductionFormat for each session is:• Demographics
• What is hyperglycemia?• Diabetes knowledge
• Acculturation• Glucose self-monitoring• Review of previously learned content• Diabetes-related health beliefs
• Family, medical, and medication history• Dietary principles for Mexican American foods• Glycosylated hemoglobin
• Assessment of participants’ knowledge and skills regarding area under discussion• Fasting blood glucose
• Diabetes knowledge• Food preparation• Systolic and diastolic blood pressure
• Diabetes-related health beliefs• Food labels (trip to grocery store)
• Glycosylated hemoglobin• Discussion of ongoing barriers to adopting healthy lifestyle changes—group problem solving• Total cholesterol HDL cholesterol LDL cholesterol
• Fasting blood glucose• Medications
• Systolic and diastolic blood pressure• Exercise
• Hygiene: illness days, foot care, etc.• Triglycerides
• Total cholesterol: HDL cholesterol LDL cholesterol• Demonstration of healthy, low-fat foods• Home glucose monitoring
• Short-term complications: hyper- and hypoglycemia
• Open discussion of any topic the group chooses
• Triglycerides• Long-term complications
• Family support and community resources
Characteristics of the intervention
A) employed bilingual Mexican American nurses and dietitians from the community
B) used videotapes filmed in Starr County showing community leaders describing their experiences with diabetes (e.g., the local priest talking about why people get diabetes)
C) focused on realistic health recommendations consistent with Mexican American preferences (e.g., dietary choices)
D) offered in Spanish, the preferred language
• Intensive (52 h over 1 year)
• Longitudinal (follow-up for up to 3 years)
• Community-based schools, churches, adult day care centers, agricultural extension centers, and community health clinics sites throughout the county
• Focused for success (improving blood glucose levels rather than on weight loss, since participants had perceived they had “failed” at weight loss many times in the past)
• Designed to provide rapid, frequent feedback
• Designed to promote group problem-solving to address individuals’ health questions and issues
• Organized to obtain support from family, friends, group participants, and nurses/dietitians/community workers
• Conducted in a community where Mexican Americans are the majority group, a community that serves as an excellent clinical laboratory for testing interventions for Mexican Americans
• Based on results of four meta-analytic reviews of related diabetes literature and 6 years of developing/testing culturally appropriate Spanish-language educational materials, particularly videotapes, and the intervention.
  • Reprinted with permission from The Diabetes Educator.