Improving Self-management of Type 2 Diabetes in Latinx Patients: Protocol for a Sequential Multiple Assignment...

Area of Science:

• Public Health
• Nursing Research
• Health Disparities

Background:

• Mexican American adults have a 16.3% Type 2 diabetes mellitus (T2DM) rate, double that of non-Hispanic White individuals.
• Existing diabetes self-management interventions for Spanish-speaking Latinx patients show promise but lack guidance on optimal application.
• Efficient resource allocation and maximized treatment outcomes for T2DM in Mexican Americans are public health priorities.

Purpose of the Study:

• To describe an adaptive intervention integrating community health workers, nurse educators, family, and patients as care partners.
• To promote diabetes self-management among Mexican American individuals with T2DM.
• To determine the most efficient sequence of evidence-based, culturally tailored treatments for this population.

Main Methods:

• A sequential multiple assignment randomized trial involving 330 Spanish-speaking Latinx patients with T2DM.
• Phase 1: Random assignment to "Tomando Control" educational program led by community health workers or diabetes nurse educators.
• Phase 2: Non-improvers rerandomized to augmented "Tomando Control" or multifamily group problem-solving treatment.

Main Results:

• Study funded June 2016, recruitment March 2017-September 2020.
• Interventions completed December 2020; data collection completed December 2021.
• Data analysis expected Spring 2023; results publication Fall 2023.

Conclusions:

• Results will inform practitioners on selecting optimal approaches for T2DM self-management.
• This research aims to improve diabetes control and reduce complications in Mexican American populations.
• Findings will support efficient and effective diabetes care strategies for Spanish-speaking Latinx patients.