title: Medical assistant coaching to support diabetes self-care among low-income racial/ethnic minority populations: randomized controlled trial.
abstract: Innovative, culturally tailored strategies are needed to extend diabetes education and support efforts in lower-resourced primary care practices serving racial/ethnic minority groups. A randomized controlled trial (RCT) examined the effect of a diabetes self-care coaching intervention delivered by medical assistants and the joint effect of intervention and ethnicity over time. The randomized repeated-measures design included 270 low-income African American and Hispanic/Latino patients with type 2 diabetes. The 1-year clinic- and telephone-based medical assistant coaching intervention was culturally tailored and guided by theoretical frameworks. A1C was obtained, and a self-care measure was completed at baseline, 6 months, and 12 months. Data were analyzed using mixed-effects models with and without adjustment for covariates. There was a significant overall improvement in mean self-care scores across time, but no intervention effect. Results revealed differences in self-care patterns across racial/ethnic subgroups. No differences were found for A1C levels across time or group.
authors.affiliation: University of Illinois at Chicago, USA lruggier@uic.edu.
authors.forename: Laurie
authors.initials: L
authors.lastname: Ruggiero
authors.affiliation: University of Illinois at Chicago, USA.
authors.forename: Barth B
authors.initials: BB
authors.lastname: Riley
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Hernandez
authors.affiliation: University of Illinois at Chicago, USA.
authors.forename: Lauretta T
authors.initials: LT
authors.lastname: Quinn
authors.affiliation: University of Illinois at Chicago, USA Jesse Brown VA Medical Center, Chicago, IL, USA.
authors.forename: Ben S
authors.initials: BS
authors.lastname: Gerber
authors.affiliation: University of Illinois at Chicago, USA.
authors.forename: Amparo
authors.initials: A
authors.lastname: Castillo
authors.affiliation: Governors State University, Chicago, IL, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Day
authors.affiliation: Rush University, Chicago, IL, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Ingram
authors.affiliation: University of Illinois at Chicago, USA.
authors.forename: Yamin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Mount Sinai Medical Center of Chicago, IL, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Butler
mesh_terms: D001741:Black or African American / Q000193:education* / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000628:therapy*; D006630:Hispanic or Latino / Q000193:education* / Q000706:statistics & numerical data; D006801:Humans; D010353:Patient Education as Topic / Q000379:methods* / Q000592:standards; D011203:Poverty / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012648:Self Care / Q000379:methods* / Q000592:standards; D013689:Telephone / Q000706:statistics & numerical data
keywords: diabetes mellitus; health behavior; minority; self-management