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PICOT question: In Asian Americans with type 2 diabetes (P), does a culturally tailored diabetes education program, including patient-specific dietary and lifestyle modifications, (I) reduce A1C levels (O) after 2 months (T) versus a control group of Asian Americans?
Introduction with a problem statement
Type 2 diabetes is a prevalent and growing problem throughout the modern world. The United States especially has seen an increase in type 2 diabetes cases in non-white people. Asian Americans are a notable segment of the American population that develop type 2 diabetes. Intervention strategies aimed at reducing certain markers like HbA1C levels may see improvement if culturally tailored methods are implemented. This essay is aimed at evaluating the effectiveness of a culturally tailored diabetic educational intervention to reduce HbA1C levels among Asian-Americans with type 2 diabetes.
Brief synthesized review.
Racial and ethnic minorities are experiencing a rise in type 2 diabetes cases. “Diabetes is a growing health epidemic in the United States. Racial and ethnic minorities are disproportionately affected by diabetes and associated comorbidities and complications” (Fayfman & Haw, 2017, p. 239). This problem must be addressed. However, because diverse cultures exist within these populations, it can be difficult to formulate and implement an appropriate intervention method. Therefore, the need arises to research if culturally tailored intervention strategies can be more useful and effective at improving certain diabetes markers like HbA1C.
Of the articles researched, a handful demonstrated results that proved such diabetes programs can be effective at improving these markers along with other key markers like psychobehavioral patterns. “…culturally tailored diabetes programs are effective at improving patients’ objectively measured clinical outcomes,...
Patients were also highly satisfied with bilingual health care providers and bilingual educational programs” (Joo, 2014, p. 605). In addition, with improvement of specific markers, people within the program detailed their satisfaction with bilingual options for communication. Often immigrants from different cultures experience language barriers when moving and living in a new country. By having bilingual health care providers, the program offers more than one way to offer solutions to the diabetes patients, encouraging better results through better adherence to the program.
Another study for Indian Immigrants with Type 2 diabetes saw marked improved in their HbA1c levels as well as key markers for health like weight and waist circumference through their own culturally tailored program. “While a significant decline in weight and increase in physical activity was observed in all participants, the intervention group lowered their HbA1c and waist circumference significantly as compared to the control group” (Patel, Misra, Raj, & Balasubramanyam, 2017, p. 1). Such effort demonstrates the possibility of tailoring plans to suit the needs of people from different cultures while also providing the parameters for successful compliance and adherence to the treatment plan through bilingual aids and self-reporting measures. Varying cultures have their own means of communicating, dietary habits, and even alternative medicine routes that can also be useful in development of intervention strategies.
Some people from Asian communities like Chinese immigrants for example, have long-standing traditions related to Chinese Medicines that use herbs and tinctures. These Chinese herbal medicines are often imported from China to the United States for alternative treatment options for diabetes type 2 management and management of other chronic…
References
Devonish, J. A., Singh, S., Tomkinson, E., & Morse, G. D. (2017). Novel Considerations about Diabetes Management Strategies in Chinese Immigrants in America: Possible Corollaries of the Use of Traditional Chinese Medicines. INNOVATIONS in pharmacy, 8(2), 1. doi:10.24926/iip.v8i2.509
Fayfman, M., & Haw, S. (2017). Diabetes in Racial and Ethnic Minorities in the United States: Individualizing Approaches to Diagnosis and Management. Current Diabetes Reviews, 13(3), 239-250. doi:10.2174/1573399812666160926142036
Joo, J. Y. (2014). Effectiveness of Culturally Tailored Diabetes Interventions for Asian Immigrants to the United States. The Diabetes Educator, 40(5), 605-615. doi:10.1177/0145721714534994
Patel, R. M., Misra, R., Raj, S., & Balasubramanyam, A. (2017). Effectiveness of Culturally Tailored Diabetes Interventions for Asian Immigrants to the United States. Journal of Diabetes Research, 2017, 1-13. doi:10.1155/2017/2751980
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