Table 1

Description of the interventions*

Standard DSMEAdapted DSME
Materials and approach• Used individual motivational interviewing techniques and individual goal setting • Used food models showing the portion size of foods• Adapted to be culturally sensitive on the basis of stakeholder input (e.g., culturally specific language, context, pictures of Pacific Islanders) • Embraced the Marshallese spiritual belief system • Used “talk story” as a conversational, rhythmic, and culturally preferred way of sharing knowledge • Used collective motivational interviewing techniques and collective (family) goal setting • Used analogies and metaphors common in Pacific Islander culture and nature in the Pacific Islands (e.g., sea tide and fishing) • Applied culturally specific concepts and beliefs (e.g., importance of supporting family members and taking care of older adults) • Identified culturally specific nutritional strengths (e.g., fish) and weaknesses (e.g., rice and sweets) and conducted cooking demonstrations • Used anatomical models and picture-based posters showing parts of human anatomy and food models showing the portion size of foods
Mode of deliveryDelivered by a CDE with interpretation by a bilingual interpreterDelivered in Marshallese by a bilingual CHW with support from a CDE
Dosage10 h delivered in 100-min sessions over 6 weeks10 h delivered in 75-min sessions over 8 weeks
ParticipantsGroups of participants with type 2 diabetesIndividual participants with type 2 diabetes and their family members
SettingsDelivered in a conveniently located community centerDelivered in participants’ homes
  • Table adapted from Kim Yeary et al. (23).

  • *Both interventions covered eight core topics: healthy eating, being active, glucose monitoring, understanding blood glucose and taking medications, problem solving, reducing risks and healthy coping, mitigating complications of diabetes, and goal setting.

  • †Intervention adaptation process described in detail by Yeary et al. (22).