López Lenny, Tan-McGrory Aswita, Horner Gabrielle, Betancourt Joseph R
Disparities Solutions Center, Massachusetts General Hospital, Boston, MA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA; Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA; Brigham and Women's Hospital, Boston, MA.
Disparities Solutions Center, Massachusetts General Hospital, Boston, MA; Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA.
J Diabetes Complications. 2016 Apr;30(3):554-60. doi: 10.1016/j.jdiacomp.2015.12.003. Epub 2015 Dec 8.
Latinos are at increased risk for obesity and type 2 diabetes (T2D). Well-designed information technology (IT) interventions have been shown to be generally efficacious in improving diabetes self-management. However, there are very few published IT intervention studies focused on Latinos. With the documented close of the digital divide, Latinos stand to benefit from such advances. There are limited studies on how best to address the unique socio-cultural-linguistic characteristics that would optimize adoption, use and benefit among Latinos. Successful e-health programs involve frequent communication, bidirectionality including feedback, and multimodal delivery of the intervention. The use of community health workers (CHWs) has been shown consistently to improve T2D outcomes in Latinos. Incorporating CHWs into eHealth interventions is likely to address barriers with technology literacy and improve patient activation, satisfaction and adherence. Additionally, tailored interventions are more successful in improving patient activation. It is important to note that tailoring is more than linguistic translation; tailoring interventions to the Latino population will need to address educational, language, literacy and acculturation levels, along with unique illness beliefs and attitudes about T2D found among Latinos. Interventions will need to go beyond the lone participant and include shared decision making models that incorporate family members and friends.
拉丁裔人群患肥胖症和2型糖尿病(T2D)的风险更高。精心设计的信息技术(IT)干预措施已被证明在改善糖尿病自我管理方面总体上是有效的。然而,针对拉丁裔人群的已发表的IT干预研究非常少。随着数字鸿沟的明显缩小,拉丁裔人群有望从这些进展中受益。关于如何最好地应对那些能优化拉丁裔人群对IT干预措施的采用、使用及从中受益的独特社会文化语言特征的研究有限。成功的电子健康项目包括频繁沟通、双向性(包括反馈)以及干预措施的多模式交付。一直以来,社区卫生工作者(CHW)的使用已被证明能改善拉丁裔人群的T2D治疗效果。将CHW纳入电子健康干预措施可能会解决技术素养方面的障碍,并提高患者的积极性、满意度和依从性。此外,量身定制的干预措施在提高患者积极性方面更成功。需要注意的是,量身定制不仅仅是语言翻译;针对拉丁裔人群量身定制干预措施需要考虑教育、语言、读写能力和文化适应水平,以及拉丁裔人群中发现的关于T2D的独特疾病观念和态度。干预措施需要超越个体参与者,纳入包括家庭成员和朋友在内的共同决策模式。