Characteristics of successful interventions included using problem solving with the patient , culturally tailoring the intervention , and using a nurse educator .
OBJECTIVE The use of behavioral interventions has been shown to improve glycemic control , however , the effectiveness of different behavioral interventions in one of the most high risk population s , African Americans , remains unclear .
Our systematic review identified and examined findings of published behavioral interventions targeted at African Americans to improve glycemic control .
The goal of our study was to distinguish which interventions were effective and identify areas for future research .
Glycemic Control and Health Disparities in Older Ethnically Diverse Underserved Adults With Diabetes
OBJECTIVE The Informatics for Diabetes Education and Telemedicine ( IDEATel ) project r and omized ethnically diverse underserved older adults with diabetes to a telemedicine intervention or usual care .  Intervention participants had lower A1C levels over 5 years . New analyses were performed to help better underst and this difference . RESEARCH DESIGN AND METHODS IDEATel r and omized Medicare beneficiaries with diabetes ( n = 1,665 ) to receive home video visits with a diabetes educator and upload glucose levels every 4–6 weeks or usual care ( 2000–2007 ) . Annual measurements included BMI , A1C ( primary outcome ) , and completion of question naires . Mixed-model analyses were performed using r and om effects to adjust for clustering within primary care physicians . RESULTS At baseline , A1C levels  ( mean ± SD ) were 7.02 ± 1.25 % in non-Hispanic whites ( n = 821 ) , 7.58 ± 1.78 % in non-Hispanic blacks ( n = 248 ) , and 7.79 ± 1.68 % in Hispanics ( n = 585 ) . Over time , lower A1C levels were associated with more glucose uploads ( P = 0.02 ) and female sex ( P = 0.002 ) . Blacks , Hispanics , and insulin-users had higher A1C levels than non-Hispanic whites ( P < 0.0001 ) . BMI was not associated with A1C levels . Blacks and Hispanics had significantly fewer uploads than non-Hispanic whites over time . Hispanics had the highest baseline A1C levels and showed the greatest improvement in the intervention , but , unlike non-Hispanic whites , Hispanics did not achieve A1C levels < 7.0 % at 5 years . CONCLUSIONS Racial/ethnic disparities were observed in this cohort of underserved older adults with diabetes . The IDEATel telemedicine intervention was associated with improvement in glycemic control , particularly in Hispanics , who had the highest baseline A1C levels , suggesting that telemedicine has the potential to help reduce disparities in diabetes management
Characteristics of successful interventions included using problem solving with the patient , culturally tailoring the intervention , and using a nurse educator .
OBJECTIVE The use of behavioral interventions has been shown to improve glycemic control , however , the effectiveness of different behavioral interventions in one of the most high risk population s , African Americans , remains unclear .
Our systematic review identified and examined findings of published behavioral interventions targeted at African Americans to improve glycemic control .
The goal of our study was to distinguish which interventions were effective and identify areas for future research .