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  • 1
    In: The Diabetes Educator, SAGE Publications, Vol. 39, No. 6 ( 2013-11), p. 761-771
    Abstract: The purpose of this article is to answer key implementation questions from our translation research with a primary care–based, nurse–community health worker (CHW) team intervention to support type 2 diabetes self-management. Methods Descriptive data are given on intervention delivery, CHW visit content, patient safety, and intervention costs, along with statistical analyses to examine participant characteristics of higher attendance at visits. Results In the intervention sample (n = 104), 74% (SD = 16%) of planned intervention visits occurred, guided by an algorithm-based protocol. Higher risk participants had a significantly lower dose of their weekly assigned visits (66%) than those at moderate (74%) and lower risk (90%). Twenty-eight percent of participants moved to a lower risk group over the year. Estimated intervention cost was $656 per person. Participants with less education were more likely to attend optimal percentage of visits. Conclusions A nurse-CHW team can deliver a culturally adapted diabetes self-management support intervention with excellent fidelity to the algorithm-based protocols. The team accommodated participants’ needs by meeting them whenever and wherever they could. This study provides an example of adaptation of an evidence-based model to the Samoan cultural context and its resource-poor setting.
    Type of Medium: Online Resource
    ISSN: 0145-7217 , 1554-6063
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 3062380-7
    detail.hit.zdb_id: 2173745-9
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  • 2
    Online Resource
    Online Resource
    SAGE Publications ; 1993
    In:  The International Journal of Psychiatry in Medicine Vol. 23, No. 2 ( 1993-06), p. 195-207
    In: The International Journal of Psychiatry in Medicine, SAGE Publications, Vol. 23, No. 2 ( 1993-06), p. 195-207
    Abstract: The current study examined regimen compliance in pregnant women with pre-existing (overt) diabetes across multiple self-care tasks at three times during the pregnancy: mid-second, early third, and late third trimesters. Method: Forty-nine pregnant women with Type I (68%) or Type II (32%) diabetes completed measures to assess compliance with the diabetic regimen, major and minor life stressors, and social support for the diabetic regimen. Results: Pregnant women with overt diabetes generally reported being compliant with their self-care regimen. There were, however, notable differences in reported compliance levels across different regimen tasks. Specifically, 74 to 79 percent of women reported being always compliant with dietary recommendations compared to 86 to 88 percent for insulin administration, 85 to 89 percent in managing insulin reactions, and 94 to 96 percent for glucose testing. Furthermore, stress in the form of major and minor life events and regimen-related social support were significantly related to self-reported compliance with dietary recommendations. There was no relationship between compliance and blood glucose levels. Conclusions: These findings suggest that psychiatric consultants focus on ways to increase social support as one means of improving compliance in pregnant women with diabetes.
    Type of Medium: Online Resource
    ISSN: 0091-2174 , 1541-3527
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1993
    detail.hit.zdb_id: 2071478-6
    SSG: 5,2
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  • 3
    In: Chronic Illness, SAGE Publications, Vol. 10, No. 2 ( 2014-06), p. 122-134
    Abstract: To examine the impact of a successful 12-month behavioral intervention to improve diabetes control on health care utilization in American Samoa. Methods A cluster-randomized design was used to assign 268 diabetes patients to a nurse-community health worker intervention or usual care. Hospitalizations, emergency department, and primary care physician visits were collected retrospectively for 1 year prior to, and during, the intervention to assess changes in health care utilization. The association of utilization changes with change in HbA1c during the intervention was assessed. Results Adjusted incidence rate ratios (RR) for primary care physician visits were significantly higher in the community health worker relative to the usual care group (RR = 1.71; 95% CI, 1.25–2.33). There was no main intervention effect on emergency department utilization, but visits in the prior year modified the intervention effect on emergency department visits. Increased primary care physician utilization was associated with greater decreases in HbA1c ( b = −0.10, SE = 0.04, p = 0.01). Conclusions A culturally adapted community health worker diabetes intervention in American Samoa significantly increased primary care physician visits, and decreased emergency department visits among those with high emergency department usage in the prior year. These changes suggest important and beneficial impacts on health system utilization from the diabetes intervention in a low resource and high-risk population.
    Type of Medium: Online Resource
    ISSN: 1742-3953 , 1745-9206
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2183572-X
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  • 4
    Online Resource
    Online Resource
    SAGE Publications ; 1996
    In:  Psychological Reports Vol. 79, No. 3_suppl ( 1996-12), p. 1339-1348
    In: Psychological Reports, SAGE Publications, Vol. 79, No. 3_suppl ( 1996-12), p. 1339-1348
    Abstract: A modified version of Spielberger's 1988 Anger Expression Inventory including four Samoan culture-specific anger terms was administered to 593 adult American and Western Samoans, 25 to 55 years, to assess intrasample age, sex, and location differences and to examine its cross-cultural utility by an exploratory factor analysis. American Samoans men's and women's scores showed greater difficulty controlling anger than Western Samoan men and women, American Samoan males scored higher on Anger-Out and Samoan anger expression than Western Samoan men, and Western Samoan women scored higher on Anger-Out and higher on Samoan anger expression than Western Samoan men. Factor analysis showed that Spielberger's original factor structure was replicated in all subpopulations except American Samoan women. Control of anger, a Samoan cultural core value, appears to be more difficult in modern American Samoans of both sexes compared with the more traditional Western Samoans. Among American Samoan women, we speculate that role expansion may be responsible for their heterogeneous factor structure of anger expression.
    Type of Medium: Online Resource
    ISSN: 0033-2941 , 1558-691X
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1996
    detail.hit.zdb_id: 2066930-6
    SSG: 5,2
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  • 5
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 13, No. 1 ( 2002-01-01), p. 25-28
    Abstract: Dried blood spots (DBS) on filter paper have been used as a practical method of sample collection in sero-surveillance studies of numerous diseases. DBS may be particularly useful for HIV screening in remote areas, in which unrefrigerated transfer time to a laboratory may take a number of days. In this study, we evaluate the ability to detect human immunodeficiency virus (HIV) type-1 antibodies from DBS that have been subjected to a tropical climate in southern India for 6 days. DBS were prepared from blood samples of 59 known HIV-positive individuals and 30 known HIV-negative individuals. ELISA and Western blot results from DBS that were subjected to a mean temperature of 35.8°C and humidity of 73% for 6 days had a sensitivity of 100% and 92%, respectively, and a specificity of 100% and 100%, respectively. Based on these findings, we conclude that DBS sampling could serve as a cost-effective and convenient tool for widespread HIV sero-surveillance in remote areas within tropical countries.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2002
    detail.hit.zdb_id: 2009782-7
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