A new Johns Hopkins University School of Nursing (JHUSON) study will test a community-based glucose control intervention program for Korean American immigrants who have type-2 diabetes mellitus.
Nurse researcher and JHUSON professor Miyong Kim, PhD, RN, FAAN, has been awarded a $3.1 million grant for the study. Throughout her career, Kim has conducted immigrant-community-based, culturally-sensitive research aimed at educating people on better health and preventing disease. Her five-year study, which started this month, will involve patients in the Baltimore-Washington area.
A pilot study Kim conducted in the Washington-Baltimore area from 2006 to 2008 that included 79 participants with type-2 diabetes yielded what Kim called "very promising results" -- a more-than one percent hemoglobin A1C reduction in the intervention group -- and shed "much light upon diabetes mellitus control and [the] prevention of life-threatening complications."
The intervention in both the pilot and the upcoming studies have three key components: a culturally-sensitive education program to develop skills patients can utilize to control their diabetes; a glucose and blood pressure machine with a phone transmission system to assist in self-monitoring; and telephone counseling and case management by a bilingual nurse who prepares participants to better communicate with their medical providers.
Kim's new study is being done to increase Korean American patients' ability to manage diabetes, which in turn will prevent complications. According to Kim, Korean Americans are among the most medically underserved ethnic groups in the country. Her previous research found that a high number of Korean American immigrants suffer from uncontrolled diabetes and that their lack of adequate health care results in part from their sense of isolation due to language and cultural barriers. More than half of Korean American immigrants, she said, lack health insurance; few go for routine checkups. Their risk for diabetes is increased by the fact that Asian migrants to the West tend to gain weight and develop type-2 diabetes and other chronic diseases.
Low health literacy among Korean immigrants is worsening "the already high rates of undetected, undertreated or poorly managed chronic illnesses, often leading to costly and tragic consequences," Kim said.
The prevalence of diabetes among Asian Americans generally and Korean Americans specifically is "alarmingly high" and requires "immediate attention," she explained. "There is a strong need for effective, community-based interventions. This community-based diabetes intervention project is the very first of its kind for Korean Americans during their U.S. immigration history, which dates more than 100 years."
Professor Kim also directs JHUSON's Research Center for Cardiovascular Health in Vulnerable Populations, which works to reduce disparities in care and treatment. The research center recently received a four-year, $1.9 million NIH grant. In addition, Professor Kim and her research team colleagues are conducting a similar 5-year community-based intervention trial targeting for hypertensive Korean Americans funded by NHLBI, NIH.