title: Dosage effects of diabetes self-management education for Mexican Americans: the Starr County Border Health Initiative.
abstract: OBJECTIVE
  The objective of this study was to compare two diabetes self-management interventions designed for Mexican Americans: "extended" (24 h of education, 28 h of support groups) and "compressed" (16 h of education, 6 h of support groups). Both interventions were culturally competent regarding language, diet, social emphasis, family participation, and incorporating cultural beliefs.
  
  
  METHODS
  We recruited 216 persons between 35 and 70 years of age diagnosed with type 2 diabetes >/=1 year. Intervention groups of eight participants and eight support persons were randomly assigned to the compressed or extended conditions. The interventions differed in total number of contact hours over the year-long intervention period, with the major difference being the number of support group sessions held. The same information provided in the educational sessions of the extended intervention was compressed into fewer sessions, thus providing more information during each group meeting.
  
  
  RESULTS
  The interventions were not statistically different in reducing HbA(1c); however, both were effective. A "dosage effect" of attendance was detected with the largest HbA(1c) reductions achieved by those who attended more of the extended intervention. For individuals who attended >/=50% of the intervention, baseline to 12-month HbA(1c) change was -0.6 percentage points for the compressed group and -1.7 percentage points for the extended group.
  
  
  CONCLUSIONS
  Both culturally competent diabetes self-management education interventions were effective in promoting improved metabolic control and diabetes knowledge. A dosage effect was evident; attending more sessions resulted in greater improvements in metabolic control.
authors.affiliation: School of Nursing, The University of Texas at Austin, P.O. Box 7426, Austin, Texas 78713, USA. sabrown@mail.utexas.edu
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Brown
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Blozis
authors.forename: Kamiar
authors.initials: K
authors.lastname: Kouzekanani
authors.forename: Alexandra A
authors.initials: AA
authors.lastname: Garcia
authors.forename: Maria
authors.initials: M
authors.lastname: Winchell
authors.forename: Craig L
authors.initials: CL
authors.lastname: Hanis
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000534:rehabilitation*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007802:Language; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010353:Patient Education as Topic; D011203:Poverty; D012648:Self Care; D012944:Social Support; D013781:Texas
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
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