Outcomes from a Multiple Risk Factor Diabetes Self-Management Trial for Latinas: ¡Viva Bien!

Oregon Research Institute, Eugene, OR, 97403-1983, USA.
Annals of Behavioral Medicine (Impact Factor: 4.2). 06/2011; 41(3):310-23. DOI: 10.1007/s12160-010-9256-7
Source: PubMed


Culturally appropriate interventions are needed to assist Latinas in making multiple healthful lifestyle changes.
The purpose of this study was to test a cultural adaptation of a successful multiple health behavior change program, ¡Viva Bien!
Random assignment of 280 Latinas with type 2 diabetes to usual care only or to usual care + ¡Viva Bien!, which included group meetings for building skills to promote the Mediterranean diet, physical activity, stress management, supportive resources, and smoking cessation.
¡Viva Bien! participants compared to usual care significantly improved psychosocial and behavioral outcomes (fat intake, stress management practice, physical activity, and social-environmental support) at 6 months, and some improvements were maintained at 12 months. Biological improvements included hemoglobin A1c and heart disease risk factors.
The ¡Viva Bien! multiple lifestyle behavior program was effective in improving psychosocial, behavioral, and biological/quality of life outcomes related to heart health for Latinas with type 2 diabetes.

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Available from: Deborah J Toobert, Jul 15, 2014
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    • "It is assumed that these approaches incorporate multiple constructs and strategies to facilitate behavior change and maintenance (44). The constructs of social cognitive theory such as self-efficacy and social support were the most frequently used, with positive results in changing physical activity level (22, 24, 25, 33, 35, 37, 42) and improving glycemic control (22, 25, 33). However, this review is not able to provide the evidence to recommend the most suitable health behavior theories for future interventions. "
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    ABSTRACT: Introduction: Type 2 diabetes mellitus (T2DM) among people aged 60 years and above is a growing public health problem. Regular physical activity is one of the key elements in the management of T2DM. Recommendations suggest that older people with T2DM will benefit from regular physical activity for better disease control and delaying complications. Despite the known benefits, many remain sedentary. Hence, this review assessed interventions for promoting physical activity in persons aged 65 years and older with T2DM. Methods: A literature search was conducted using Ovid MEDLINE, PubMed, EMBASE, SPORTDiscus, and CINAHL databases to retrieve articles published between January 2000 and December 2012. Randomized controlled trials and quasi-experimental designs comparing different strategies to increase physical activity level in persons aged 65 years and older with T2DM were included. The methodological quality of studies was assessed. Results: Twenty-one eligible studies were reviewed, only six studies were rated as good quality and only one study specifically targeted persons aged 65 years and older. Personalized coaching, goal setting, peer support groups, use of technology, and physical activity monitors were proven to increase the level of physical activity. Incorporation of health behavior theories and follow-up supports also were successful strategies. However, the methodological quality and type of interventions promoting physical activity of the included studies in this review varied widely across the eligible studies. Conclusion: Strategies that increased level of physical activity in persons with T2DM are evident but most studies focused on middle-aged persons and there was a lack of well-designed trials. Hence, more studies of satisfactory methodological quality with interventions promoting physical activity in older people are required.
    Full-text · Article · Dec 2013 · Frontiers in Public Health
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    • "Conventional wisdom has been that it is not possible to treat multiple behaviors simultaneously , because it is too burdensome and places too many demands on a person's inherent ability to change (Johnson et al., 2008). However, MHBC interventions for a common health objective, for example, cancer prevention, diabetes self-management, or weight management, have shown significant impact on multiple behavior changes (Lippke, Nigg, & Maddock, 2011; Mays et al., 2011; Toobert, Strycker, Barrera, et al., 2011; Toobert, Strycker, King, et al., 2011). MHBC interventions incorporate the covariation/coaction principle by which individuals taking effective action on one target behavior are more likely to take effective action on a second behavior and are likely to take effective action on untreated behaviors related to the treated behaviors (Blissmer et al., 2010; J. O. Prochaska, 2008). "

    Full-text · Article · Apr 2012 · Health Education & Behavior
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    • "), and from a formal efficacy trial (Barrera, Toobert, Strycker, Osuna, King, & Glasgow, 2011; Toobert et al., 2011). Second, reviewers dealing with a variety of health topics have concluded almost uniformly that culturally appropriate health interventions were more effective than usual care or other control conditions. "
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    ABSTRACT: Objective: To reduce health disparities, behavioral health interventions must reach subcultural groups and demonstrate effectiveness in improving their health behaviors and outcomes. One approach to developing such health interventions is to culturally adapt original evidence-based interventions. The goals of the article are to (a) describe consensus on the stages involved in developing cultural adaptations, (b) identify common elements in cultural adaptations, (c) examine evidence on the effectiveness of culturally enhanced interventions for various health conditions, and (d) pose questions for future research. Method: Influential literature from the past decade was examined to identify points of consensus. Results: There is agreement that cultural adaptation can be organized into 5 stages: information gathering, preliminary design, preliminary testing, refinement, and final trial. With few exceptions, reviews of several health conditions (e.g., AIDS, asthma, diabetes) concluded that culturally enhanced interventions are more effective in improving health outcomes than usual care or other control conditions. Conclusions: Progress has been made in establishing methods for conducting cultural adaptations and providing evidence of their effectiveness. Future research should include evaluations of cultural adaptations developed in stages, tests to determine the effectiveness of cultural adaptations relative to the original versions, and studies that advance our understanding of cultural constructs' contributions to intervention engagement and efficacy. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
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