Culturally Appropriate Strategies for Chinese Americans With Diabetes (CASCADe)

Study Overview
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Brief Summary
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The project aimed to evaluate the implementation process and efficacy of a culturally tailored Diabetes Self-Management and Education (DSME) program with mobile health (mHealth) technology integration, entitled Culturally Appropriate Strategies for Chinese Americans with Diabetes (CASCADe), among Chinese American adults with Type 2 diabetes.

Detailed Description
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The CASCADe program includes 1) a home visit for training of monitoring devices use, WeChat app and acquiring family support, 2) 8 weekly education sessions with a combined format of group class, games, food demonstration, group exercise, video and discussion, 3) WeChat follow-up on education tips, monitoring data summary, and group discussion. The monitoring system used a smartphone to coordinate cloud data transmission from a set of wireless devices to capture daily monitoring data on physical activity, body weight, blood pressure and blood glucose levels. WeChat app was used to facilitate behavioral self-monitoring by providing daily messages related to diabetes education curriculum, weekly summary reports on monitoring data as well as reinforcement messages and group discussion on readings and monitoring results implication. A single group pre-post-test design was adopted to evaluate changes of primary (HbA1c) and secondary (Self-efficacy, quality of life and stress coping) outcomes assessed at pre and post of intervention. Engagement and adherence in education sessions and self-monitoring system, and satisfaction with the content and delivery of intervention were also evaluated at the end of the study.

Official Title
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Implementation and Evaluation of A Culturally Tailored Diabetes Self-Management Program for Chinese Americans

Conditions
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Type 2 Diabetes

Intervention / Treatment
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* Behavioral: CASCADe


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: have been diagnosed with Type 2 diabetes having been managing diabetes with diet, oral hypoglycemic agents or insulin, or both confirmed HbA1c level >=6.5% and <10% 21-75 years old residents of San Gabriel Valley speak and understand of Mandarin willing to use the smartphone-based monitoring devices provided by the project. Exclusion Criteria: unable or unwilling to give informed consent plan to move out of the area within the 1-year participation study period are or plan to be pregnant or breastfeeding in the next 12 months have a condition that inhibits movement (e.g., unable to walk unaided, or cannot walk 1/4 mile without stopping) have major physical disability or condition that prevents them from participating in person.

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Single group pre- and post-test design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CASCADe Intervention<br>Intervention consisted of eight weekly sessions of health education and diabetes management. Topics covered include recognition of diabetes and its complications, risk factors, nutrition knowledge, dietary practices, exercise, behavioral self-monitoring, medication adherence, and stress management. Intervention also included a home visit for training of monitoring devices use, WeChat app and acquiring family support, and weekly WeChat follow-up on education tips, monitoring data summary, and group discussion. The monitoring system used a smartphone to coordinate cloud data transmission from a set of wireless devices to capture daily monitoring data on physical activity, body weight, blood pressure and blood glucose levels. | Behavioral: CASCADe<br>* Culturally tailored diabetes self-management and education sessions with mHealth integration<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Concentration of HbA1c | HbA1c was assessed using the testing kit of A1C Now+ with a finger prick of blood by trained data collector. | Change from baseline HbA1c at 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Score of Self-efficacy | Chinese version of diabetes self-management self-efficacy scale included 20 items with likert-like response scale of 1-5 and minimum score of 20 and maximum score of 100. | Change from baseline Self-efficacy score at 3 months | 
| Change of Score of Quality of life | Chinese version of diabetes quality of life scale included 15 items with likert-like response scale of 1-5, and minimum score of 15 and maximum score of 75. . | Change from baseline Quality of life score at 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chinese Americans, Type 2 Diabetes, mHealth, Diabetes Self-Management and Education