Background
The effectiveness of educational programs for patients with diabetes is still a relevant issue. Different specialists claim that diabetes self-management education does not adequately address the existing problems (Christie et al., 2016). It is especially important for Hispanic patients as diabetes rates in this population are considerably higher than in others. Therefore, it is necessary to continue research in this field.
PICOT Question
To guide this project the following PICOT question has been formulated: How effectively does diabetes education (I) improve health outcomes (O) in Hispanics aged 30 to 60 with diabetes mellitus type 2 (P) in comparison with patients who do not have such knowledge and skills (C) during a 2-year time frame after being diagnosed (T)?
Strategy
The main strategy that was applied to the research was to review relevant literature that covers all aspects of diabetes education for Hispanics and demonstrates its effect on their health. It was necessary to study only credible works that were published in peer-reviewed journals. Such texts were available in different databases such as PubMed or Google Scholar.
Critical Analysis
Several articles related to the issue have been critically analyzed. For example, in the article by Rotberg, Greene, Ferez-Pinzon, Mejia, and Umpierrez (2016), the authors detected changes in medical indicators among patients with diabetes type 2 who participated in the Emory Latino Diabetes Education program. The authors described modifications in physical examinations and highlighted the impact of sociodemographic characteristics on class attendance. They concluded that the program was an effective tool in delivering diabetes self-management education and support as it improved the health outcomes of the participants. Another study by Welch et al. (2016) assessed the effect of an Internet-based diabetes management program on health outcomes in an urban Latino population. The authors compared a new educational intervention to usual diabetes care. They concluded that this method significantly improved medical indicators in Hispanics with diabetes. The results demonstrated that an Internet-based management program was more effective than usual diabetes care. Therefore, research proved that culturally appropriate interventions that aimed at enhancing engagement in follow-up care could address problems related to diabetes in Hispanics.
Steps
To answer the PICOT question, it is necessary to develop an implementation plan. The plan will consist of several steps. The first step is to choose an adequate sample size and methods. The second step is to recruit participants. The final step is to design the intervention.
The research will be carried out within medical settings. The number of participants should be a minimum of 50. Participants will be recruited from Hispanics aged 30 to 60 and diagnosed with diabetes type 2. It will be a randomized controlled trial in which the first half of the participants will form an intervention group and the second half – control group. The intervention group will attend diabetes management educational classes for ten weeks. The control group will receive usual care. Before classes, all participants will be examined to determine their A1C levels. The same data will be collected right after the end of the intervention and then during the next two years two times a year. The attendance rate for the intervention classes will also be documented. The main goal of this study is to assess the effect of educational classes on health outcomes in adult Hispanics with diabetes type two over two years.
Target population and Inclusion Criteria
The study will focus on adult Hispanic patients aged 30 to 60 with diabetes mellitus type two who receive usual diabetes care.
Exclusion Criteria
Patients who refused to provide written approval to participate in the study, who are pregnant or who have gestational diabetes or diabetes type 1, and patients who cannot attend educational classes due to whatever medical conditions will be excluded from the study.
Intervention
The intervention is based on providing free educational classes for adult Hispanics with diabetes type two. The program will consist of one-hour lessons once a week for ten weeks. The specialists who will teach classes are certified diabetes educators and nutritionists. All participants will be provided with free glucometers. The classes will focus on several main aspects. The first aspect is to identify and explain common diabetes terms, for example, A1C, blood pressure, cholesterol, different types of diabetes, their symptoms and complications, and statistics. The second aspect is to learn how to maintain normal blood sugar levels. Therefore, these classes will focus on various treatment options. Also, participants will learn about the effect that certain medications have on the body. The third aspect is nutrition. Patients will learn about the diabetes plate method and carbohydrate counting. The plate method class will explain to patients how to control portions of food as it helps to improve glycemic control and lose weight (Saslow et al., 2017). They will be taught how to use this method to plan all their meals both at home and in eating houses. The carbohydrate counting class will teach participants to detect products that contain carbohydrates and to use this technique to modify their meals. They will be explained that this method also improves glycemic control (Pearson et al., 2016). After each class, all participants will be evaluated, and after completing the entire course, they will take a final test. These data are also important for the assessment of the outcomes of the intervention.
References
Christie, D., Thompson, R., Sawtell, M., Allen, E., Cairns, J., Smith, F.,… Wiggins, M. (2016). Effectiveness of a structured educational intervention using psychological delivery methods in children and adolescents with poorly controlled type 1 diabetes: A cluster-randomized controlled trial of the CASCADE intervention. BMJ Open Diabetes Research and Care, 4(1), 1-14.
Pearson, K. K., Reiland, S. A., Meara, J. G., Brown, J. K., Fedraw, L. A., & Mapes, D. L. (2016). Improving glycemic control and insulin ordering efficiency for hospitalized patients with diabetes through carbohydrate counting. Journal for Healthcare Quality, 38(1), 1-9.
Rotberg, B., Greene, R., Ferez-Pinzon, A. M., Mejia, R., & Umpierrez, G. (2016). Improving diabetes care in the Latino population: The Emory Latino diabetes education program. American Journal of Health Education, 47(1), 1-7.
Saslow, L. R., Mason, A. E., Kim, S., Goldman, V., Ploutz-Snyder, R., Bayandorian, H.,… Moskowitz, J. T. (2017). An online intervention comparing a very low-carbohydrate ketogenic diet and lifestyle recommendations versus a plate method diet in overweight individuals with type 2 diabetes: A randomized controlled trial. Journal of Medical Internet Research, 19(2), 1-53.
Welch, G., Zagarins, S. E., Santiago-Kelly, P., Rodriguez, Z., Bursell, S. E., Rosal, M. C., & Gabbay, R. A. (2015). An Internet-based diabetes management platform improves team care and outcomes in an urban Latino population. Diabetes Care, 38(4), 561-567.