Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 16:5:1328993.
doi: 10.3389/fcdhc.2024.1328993. eCollection 2024.

Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes

Sabrina Martinez  1 , Christian N Nouryan  1   2   3 , Myia S Williams  1   2 , Vidhi H Patel  1   2 , Paulina Barbero  1 , Valeria Correa Gomez  1 , Jose Marino  1 , Nicole Goris  1 , Edgardo Cigaran  1 , Dilcia Granville  4 , Lawrence F Murray  4 , Yael T Harris  1   2 , Alyson Myers  1   2 , Josephine Guzman  1 , Amgad N Makaryus  1   2   4 , Samy I McFarlane  5 , Roman Zeltser  1   2   4 , Maria Pena  6 , Cristina Sison  1   2 , Martin L Lesser  1   2 , Myriam Kline  1 , Ralph Joseph DiClemente  7 , Renee Pekmezaris  1   2   3
Affiliations

Ensuring fidelity: key elements to consider in disseminating a diabetes telemanagement program for underserved Hispanic/Latinos living with type 2 diabetes

Sabrina Martinez et al. Front Clin Diabetes Healthc. .

Abstract

Background: The Hispanic/Latino population has greater risk (estimated >50%) of developing type 2 diabetes (T2D) and developing it at a younger age. The American Diabetes Association estimates costs of diagnosed diabetes in 2017 was $327 billion; with medical costs 2.3x higher than patients without diabetes. The purpose of this manuscript is to describe the methodology utilized in a randomized controlled trial aimed at evaluating the efficacy of a diabetes telemanagement (DTM) program for Hispanic/Latino patients with T2D. The intent is to provide information for future investigators to ensure that this study can be accurately replicated.

Methods: This study was a randomized controlled trial with 240 participants. Eligible patients (Hispanic/Latino, aged 18+, living with T2D) were randomized to Comprehensive Outpatient Management (COM) or DTM. DTM was comprised of usual care, including routine clinic visits every three months, as well as: Biometrics (a tablet, blood glucose meter, blood pressure monitor, and scale); Weekly Video Visits (facilitated in the patient's preferred language); and Educational Videos (including culturally congruent diabetes self-management education and quizzes). COM consisted of usual care including routine clinic visits every three months. For this study, COM patients received a glucometer, glucose test strips, and lancets. Establishing a therapeutic nurse-patient relationship was a fundamental component of our study for both groups. First contact (post-enrollment) centered on ensuring that patients and caregivers understood the program, building trust and rapport, creating a non-judgmental environment, determining language preference, and establishing scheduling availability (including evenings and weekends). DTM were provided with a tablet which allowed for self-paced education through videos and weekly video visits. The research team and Community Advisory Board identified appropriate educational video content, which was incorporated in diabetes educational topics. Video visits allowed us to assess patient involvement, motivation, and nonverbal communication. Communicating in Spanish, and awareness of diverse Hispanic/Latino backgrounds was critical, as using relevant and commonly-used terms can increase adherence and improve outcomes. Shared decision-making was encouraged to make realistic health care choices.

Conclusion: Key elements discussed above provide a framework for future dissemination of an evidence-based DTM intervention to meet the needs of underserved Hispanic/Latino people living with T2D.

Keywords: Hispanic; Latino; bilingual; diabetes; self-management; telemanagement; underserved.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Vidal TM, Williams CA, Ramoutar UD, Haffizulla. F. Type 2 diabetes mellitus in latinx populations in the United States: A culturally relevant literature review. Cureus (2022) 14(3):e23173. doi: 10.7759/cureus.23173 - DOI - PMC - PubMed
    1. US Census Bureau . Hispanic population to reach 111 million by 2060(2021). Census.gov. Available at: https://www.census.gov/library/visualizations/2018/comm/hispanic-project... (Accessed 26, 2023).
    1. Centers for Disease Control and Prevention . Hispanic or Latino people and type 2 diabetes(2022). CDC.gov. Available at: https://www.cdc.gov/diabetes/library/features/hispanic-diabetes.html (Accessed February 26th 2023).
    1. Aguayo-Mazzucato C, Diaque P, Hernandez S, Rosas S, Kostic A, Caballero AE. Understanding the growing epidemic of type 2 diabetes in the Hispanic population living in the United States. Diabetes Metab. Res. Rev. (2019) 35(2):e3097. doi: 10.1002/dmrr.3097 - DOI - PMC - PubMed
    1. Schneiderman N, Llabre M, Cowie CC, Barnhart J, Carnethon M, Gallo LC, et al. . Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Diabetes Care (2014) 37(8):2233–9. doi: 10.2337/dc13-2939 - DOI - PMC - PubMed

LinkOut - more resources