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mHealth Intervention for Vietnamese Living With Diabetes: Protocol for a Stepped Wedge Pilot Study
Anna Nguyen1, Zsolt Nagykaldi2, Thanh Bui2
1Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
JMIR Research Protocols
|September 28, 2023
Summary
This study evaluated a mobile health intervention for Vietnamese Americans with diabetes, showing improved self-care and clinical outcomes. The culturally tailored program, SMart-D, demonstrated feasibility and acceptability, paving the way for wider implementation.
Area of Science:
- Health Informatics
- Diabetes Management
- Cultural Health Interventions
Background:
- Diabetes self-management education improves outcomes, but language and cultural barriers hinder participation for some populations.
- Culturally tailored interventions are needed to address these disparities and improve diabetes self-management.
- The Self-Management Mobile Health Intervention for US Vietnamese With Diabetes (SMart-D) was developed to address these specific needs.
Purpose of the Study:
- To evaluate the feasibility, acceptability, and effectiveness of the SMart-D intervention.
- To assess the potential for scaling up the intervention in the future.
- To utilize the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework for comprehensive evaluation.
Main Methods:
- A 2-year stepped wedge randomized controlled pilot study involving primary care clinics and patients with type 2 diabetes.
- Clinics were randomized, transitioning from standard care to standard care plus the SMart-D intervention over 12 weeks.
- Outcomes measured included self-care behaviors (Summary of Diabetes Self-Care Activities scale) and clinical changes (laboratory tests), with qualitative data from patient and clinician interviews.
Main Results:
- Enrollment included 10 clinics and 60 patients as of August 2023.
- Hypothesized participation rates of 50% for clinics and patients, and 70% completion rate.
- Anticipated improvements in self-care behaviors and clinical outcomes, with 75% maintenance at follow-up, alongside positive feasibility and acceptability feedback.
Conclusions:
- SMart-D is the first Vietnamese diabetes self-management intervention using mobile health to overcome language and cultural barriers.
- The study will inform the implementation process and demonstrate the intervention's potential effectiveness.
- Findings may accelerate evidence-based intervention adoption for US Vietnamese and offer a replicable model for other ethnic minorities.
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