title: An automated telephone nutrition support system for Spanish-speaking patients with diabetes.
abstract: In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Participants had no significant improvement in A1c (-0.3% in the control arm, -0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland.
authors.affiliation: Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA rkhanna@medicine.ucsf.edu.
authors.forename: Raman
authors.initials: R
authors.lastname: Khanna
authors.affiliation: Santa Clara County Public Health Department, San Jose, CA, USA.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Stoddard
authors.affiliation: Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA Santa Clara County Public Health Department, San Jose, CA, USA La Clinica de la Raza, Oakland, CA, USA Instituto Nacional de Salud Publica, Mexico University of California, San Francisco Division of General Internal Medicine and Center for Vulnerable Populations, San Francisco General Hospital and Trauma Center, San Francisco, CA, USA Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Gonzales
authors.affiliation: La Clinica de la Raza, Oakland, CA, USA.
authors.forename: Mariana
authors.initials: M
authors.lastname: Villagran-Flores
authors.affiliation: La Clinica de la Raza, Oakland, CA, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Thomson
authors.affiliation: La Clinica de la Raza, Oakland, CA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Bayard
authors.affiliation: Instituto Nacional de Salud Publica, Mexico.
authors.forename: Ana Gabriela
authors.initials: AG
authors.lastname: Palos Lucio
authors.affiliation: University of California, San Francisco Division of General Internal Medicine and Center for Vulnerable Populations, San Francisco General Hospital and Trauma Center, San Francisco, CA, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: Schillinger
authors.affiliation: Instituto Nacional de Salud Publica, Mexico.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bertozzi
authors.affiliation: Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Gonzales
mesh_terms: D001331:Automation; D003376:Counseling / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy*; D004035:Diet Therapy / Q000379:methods*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D017216:Telemedicine / Q000379:methods*; D013689:Telephone
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Spanish; diabetes care; self-care; telephone nutrition support; vulnerable populations