Effectiveness of A Culturally Adapted Family Model of Diabetes Self-Management Education and Support among Marshallese Pacific Islanders Delivered in a Group Format in Churches

Abstract

Introduction: Diabetes self-management education and support (DSMES) is effective for reducing health complications among people with type 2 diabetes (PWD). However, standard DSMES interventions have not been effective for Marshallese Pacific Islanders.

Methods: A culturally adapted Family-DSMES intervention for Marshallese PWD was implemented in churches in Hawaii and Washington state and delivered by Marshal-lese community health workers. We assessed changes in hemoglobin A1c (HbA1c), body mass index (BMI), and blood pressure from pre-to post-intervention (12 weeks).

Results: One hundred eighty-five (185) participants-99 PWD and 86 family members-completed classes and had valid pre-and post-intervention HbA1c data. For PWD, there were significant decreases in HbA1c (-0.69%; p=.0000) and BMI (-0.38; p=.008).

Discussion: The clinically and statistically significant reduction in HbA1c among PWD adds evidence for the effectiveness of family models of DSMES. Results will be used to inform future interventions and research studies with Marshallese and other Pacific Islander communities.