Date of Graduation

Winter 12-7-2020

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

College/School

School of Nursing and Health Professions

Department/Program

Nursing

Program

Family Nurse Practitioner

First Advisor

Karen Van Leuven

Second Advisor

Dena Cuyjet

Abstract

Problems: Asian Americans have higher incidence and prevalence of diabetes mellitus type 2 and less preventive care and higher complication rates than the rest of the American population.

Context: According to the National Healthcare Quality and Disparities Reports (2016), Asian Americans are more likely to be diagnosed with diabetes compared to non-Hispanic whites by over ten percent.

Interventions: A comprehensive group visit program was implemented in a clinic in Oakland, Chinatown catered towards Cantonese-speaking diabetic patients. The group visit included culturally and linguistically appropriate materials related to nutrition, exercise, and diabetes knowledge. Each cohort attended a ninety-minute group visit session once a week for four consecutive weeks. One session would include time for endurance or muscle-strengthening exercise, diabetes education, nutrition tips for diabetics that would fit the Cantonese diet, and basics of mental health related to their disease process and coping.

Measures: Metrics to evaluate the efficacy of the program include pre and post-intervention HgbA1c, pre and post-intervention self-management survey, and program evaluation surveys.

Results: There was a total of 12 participants (age 61 to 85) participating in two cohorts. Results demonstrated a mean decrease in HgbA1c from 7.833 (CI = 95%, 7.8333 ±1.016) to a post-participation HgbA1c mean of 7.783 (CI = 95%, 7.7833 ±1.149). There was minimal change in HgbA1c given that the program length was only four weeks, and the HgbA1c results were drawn three months following the first blood draw. A more significant change in HgbA1c could be possible if the intervention was over a longer period of time. Self-management survey results showed an improvement in diabetes self-management for all categories assessed. Categories included confidence in understanding the cause of diabetes, importance of diabetes control, target for well-controlled diabetes, connection between physical and mental health, prevention of rapid fluctuation of glucose levels, and finding answers to questions related to diabetes. Group evaluation survey results also displayed intent for lifestyle changes secondary to the intervention for all patients.

Conclusions: The HgbA1c results showed minimal change, however there was an increase in post-participation confidence levels related to knowledge and self-care related to diabetes, and all surveyed patients reported increased learning from the group visits.

Keywords: diabetes mellitus type 2, group visit, glycemic control, Cantonese

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