title: The Effect of a Community-Based Self-Help Intervention: Korean Americans With Type 2 Diabetes.
abstract: BACKGROUND
  Korean Americans are one of the most underserved ethnic/linguistic minority groups owing to cultural and institutional barriers; there is an urgent need for culturally competent diabetes management programs in the Korean American community for those with type 2 diabetes. The purpose of this study was to test the effectiveness of a community-based, culturally tailored, multimodal behavioral intervention program in an ethnic/linguistic minority group with type 2 diabetes.
  
  
  METHODS
  An RCT with waitlist comparison based on the Predisposing, Reinforcing, and Enabling Constructs in Education/environmental Diagnosis and Evaluation (PRECEDE)-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) and self-help models. Data were collected between September 2010 and June 2013 and were analyzed in August-December 2014. Statistical significance was set at p<0.05.
  
  
  METHODS
  In a naturally occurring community setting, a total of 250 Korean Americans with type 2 diabetes were randomized into an intervention group (n=120) or a control group (n=130).
  
  
  METHODS
  The intervention consisted of key self-management skill-building activities through 12 hours of group education sessions, followed by integrated counseling and behavioral coaching by a team of RNs and community health workers.
  
  
  METHODS
  Primary (clinical) outcomes were hemoglobin A1c, glucose, total cholesterol, and low-density lipoprotein at baseline and at 3, 6, 9, and 12 months. Secondary (psychosocial and behavioral) outcomes included diabetes-related quality of life, self-efficacy, adherence to diabetes management regimen, and health literacy.
  
  
  RESULTS
  During the 12-month project, the intervention group demonstrated 1.0%-1.3% (10.9-14.2 mmol/mol) reductions in hemoglobin A1c, whereas the control group achieved reductions of 0.5%-0.7% (5.5-7.7 mmol/mol). The differences between the two groups were statistically significant. The intervention group showed statistically significant improvement in diabetes-related self-efficacy and quality of life when compared with the control group.
  
  
  CONCLUSIONS
  RN/community health worker teams equipped with culturally tailored training can be effective in helping an ethnic/linguistic minority group manage diabetes in the community.
authors.affiliation: School of Nursing, University of Texas at Austin, Austin, Texas. Electronic address: kbkim@ikorean.org.
authors.forename: Miyong T
authors.initials: MT
authors.lastname: Kim
authors.affiliation: Korean Resource Center, Ellicott City, Maryland.
authors.forename: Kim B
authors.initials: KB
authors.lastname: Kim
authors.affiliation: School of Nursing, University of California at San Francisco, San Francisco, California.
authors.forename: Boyun
authors.initials: B
authors.lastname: Huh
authors.affiliation: Connell School of Nursing, Boston College, Boston, Massachusetts.
authors.forename: Tam
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Hae-Ra
authors.initials: HR
authors.lastname: Han
authors.affiliation: School of Public Health, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Lee R
authors.initials: LR
authors.lastname: Bone
authors.affiliation: School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: David
authors.initials: D
authors.lastname: Levine
mesh_terms: D000368:Aged; D001213:Asian; D001786:Blood Glucose / Q000032:analysis; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior / Q000208:ethnology*; D057220:Health Literacy; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology*; D011788:Quality of Life; D012111:Residence Characteristics; D012648:Self Care / Q000592:standards*; D014481:United States / Q000208:ethnology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008077:Lipoproteins, LDL