Poster Presentation
Wednesday, 19 July 2006
9:30 AM - 10:00 AM
Wednesday, 19 July 2006
2:30 PM - 3:00 PM
This presentation is part of : Poster Presentations I
Feasibility of Culturally Competent Diabetes Education to Reduce Emergency Department Visits for African Americans with Diabetes
Wanda Anderson-Loftin, PhD, RN, College of Nursing, University of South Carolina, Columbia, SC, USA
Learning Objective #1: Discuss health disparities among rural African Americans that predict higher use of Emergency Departments for diabetes-related care.
Learning Objective #2: Discuss implications of a community-based, culturally competent dietary self-management intervention designed to reduce Emergency Department visits through improved health outcomes and dietary habits.
Objective:  African Americans with diabetes have greater health disparities frequently resulting in greater Emergency Department (ED) utilization and hospitalizations. Community-based diabetes self-management interventions, tailored to the African American culture, can reduce resource utilization by improving glycemic control, preventable complications, and management of multiple chronic illnesses. This study was to determine the feasibility of a culturally competent diabetes self-management intervention aimed at reducing ED visits and hospitalizations. Specific aims were: (a) evaluate effects of intervention on outcomes; (b) assess adherence; (c) assess recruitment and retention. 

Design:Longitudinal, experimental study.
Population, Sample, Setting, Years

97 high-risk, African-Americans with type 2 diabetes were recruited from a rural South Carolina county. Study dates were 2001 to 2003.

Intervention and Outcome Variables:

The intervention was dietary self-management education. Outcomes were ED visits and hospitalizationsMethods:

Participants were randomly assigned to usual care, referral to traditional diabetes education, or intervention, consisting of four, 1 ½  hour classes in practical low-fat dietary strategies, 5 monthly peer-professional group discussions, and weekly telephone follow-up by a nurse case manager.  The intervention was culturally competent in terms of ethnic beliefs, values, customs, food preferences, language, and learning methods. Data were collected by self-reported questionnaires and interview.

Findings:

A non-significant trend in reduction of ED visits was observed for a net difference of 4 visits between groups. Hospitalizations increased for the experimental group and were unchanged for the control group. Participation was 84%; retention was 78% for the experimental group versus 56% for usual care; overall retention was 67%. Mean attendance was 4.8 (SD 2.6) of 8 intervention sessions. Conclusions:
Culturally competent dietary self-management attracts large percentages of high-risk participants and may reduce ED visits, especially repeated visits, for rural, southern African-Americans. A larger experimental study is needed that offers a more attractive option to the control group than simply referral.

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