This assignment is a building block for your final Synthesis of Literature assignment. Your synthesis paper will not simply be a summary of articles you have found based on your literature search. Rat

A Community–Academic Collaboration to Support Chronic Disease Self-Management among Individuals Living in Permanent Supportive Housing

Pilot data from this study provides an example of a community–academic partnership that improved the health of individuals

Individuals experiencing chronic homelessness with a chronic health condition may qualify for permanent supportive housing (PSH). 

 Diabetes self-management as a priority health need. An evidence-based diabetes self-management program was piloted for seven weeks with diabetic (type 2) or prediabetic PSH residents.

A survey was administered at baseline and program completion.

HbA1c was assessed at baseline and 3-month follow-up.

 Those who completed the Program (N = 10), reported a significant increase in diabetes knowledge, self-efficacy, and foot self-care. The average hemoglobin A1c (HbA1c) of the participants significantly decreased from 8.86 to 6.88.

In the open-ended assessment, all participants reported that they learned something from this program.

Some reported an increase in specific knowledge.

Whereas others talked about how the program changed their perceptions

The implementation of the program had several limitations.

Despite successful outcomes for those who stayed in the program, the attrition rate was high with few participants graduating from the program.

Interpretations from the study were limited by the statistical power resulting from the small sample size which may have prevented the detection of between-person differences.

Culturally Appropriate Self-Management Program for Hispanic Adults with Type 2 Diabetes and Low Health Literacy Skills

This study assessed the feasibility of adapting a patient-centered educational intervention for type 2 diabetes (T2D) self-management for a Hispanic population with low health literacy skills.

The rural community health center from which the participants were recruited provides primary health care to an underserved and underinsured population.

Effective interventions for lowering HbA1c levels included the use of low carbohydrate or low glycemic load diets, physical activity, and the use of glucose self-monitoring, in a diabetes self-management program.

Participants’ feedback clustered around four themes: information and knowledge, motivation and barriers to change, experiences with new behaviors, and personal responsibility.

The findings may help in further development of tools and strategies for improved T2D self-management in the study population.

Limitations of this study include the potential for biases related to participant self-selection and the fact that the Spanish-speaking group facilitator also presented the content. Another limitation was that the group participants had a lower level of health literacy skills than anticipated, which provided linguistic challenges 

This descriptive qualitative study used a phenomenological approach

A Group-Based Peer Support Program for Low-Income African Americans with Type 2 Diabetes: A Descriptive Phenomenological Study

The purpose of this study was to explore and describe the meaning and essence of the experiences, perceptions of African American adults with type 2 diabetes who participated in a peer support program to promote diabetes self-management

A convenience sample of 20 participants were drawn from two peer support programs African American with type 2 diabetes in a city in the southeastern region of the United States. Included in the peer support programs were Medicaid and uninsured patients.

The peer support programs were organized and supervised by nurses. In addition to the monthly meetings, the trained peer supporters called or visited the patients at least once in two weeks. Many of them HGBA1c. The peer supporters who themselves have diabetes and were doing well with their disease management (A1C of 7 and below).

Twenty participants were interviewed for the study, comprising 13 females and seven males aged between 30 - 82 years. Five participants were married, 14 were single/ divorced, four attended some high school, nine completed high school, seven attended some college, four were employed, 11 were unemployed, and four were retired.

Several researchers have demonstrated the benefits of peer support in terms of enhanced disease control, cost-effectiveness, reaching low-income rural dwellers, and psychosocial well-being

A limitation of this study is that participants were sampled from only two peer support programs in one city in the Southeastern United States, limiting the generalizability of findings. T

The philosophical underpinning that guided this study is descriptive phenomenology

A Patient-Centered Approach Using Community-Based Paraprofessionals to Improve Self-Management of Type 2 Diabetes

The purpose of this study was to examine the impact of a 10-week lifestyle management program delivered by community-based paraprofessionals in improving clinical markers and dietary behaviors related to diabetes control in an underserved population.

A total of 156 people completed baseline data collection and enrolled in the program. In particular, 57% were Caucasian, 37% were African American, 3% were Hispanic, and 3% were American Indian/Alaskan Native. Participants were 27 to 83 years of age (mean age was 55 years) and 76% were female.

Participants in Diabetes Health: Its in Your Hands met for 10 weeks—one time each week for approximately 90 minutes. Each of the 10 sessions was led by a trained MSU-E paraprofessional who was supervised by county-based professional staff 

Paired t tests indicated significant changes for: HbA1c (P < .001), BMI (P < .05), smoking tobacco (P < .05), fruit and vegetable intake (P < .01), and appraisal of diabetes scores (P < .001).

A significant decrease in HbA1c levels (P < .001) and BMI (P < .05) from baseline to follow-up.  a higher score indicates a movement toward positive health-related changes, such as decreasing tobacco smoking or increasing fruit and vegetable intake. 

The absence of a control group may be perceived as a study limitation.

A quasi-experimental design that was more appropriate for our real-world situation.

A Pilot Study of Diabetes Education via Telemedicine in a Rural Underserved Community—Opportunities and Challenges

Purpose Telemedicine technology may offer an avenue to implement diabetes self-management education (DSME) for people with diabetes in underserved rural communities.

 A pilot study was conducted in 2006, implementing a DSME-T at the University of Arkansas for Medical Sciences and a rural community hospital in Arkansas (Ozark Health, Inc). A total of 38 people were enrolled to receive DSME-T.

The American Diabetes Association recommends that DSME be provided to patients by a registered dietician and nurse, following a core curriculum.

Results A total of 66% of participants (n = 25) completed the DSME-T program. A significantly greater proportion of participants demonstrated improved knowledge (39% vs 83%; P = .012), endorsed greater self-efficacy (54% vs 86%; P = .016), and reported more frequent self-care practices to manage their diabetes at the conclusion of the study period.

Plans are in place to explore the possibility of sustaining and expanding the program to other underserved rural communities.

Limited to the campus of University of Arkansas. Most of these studies were conducted in urban settings with adequate access to diabetes care. Studies on DSME in rural underserved communities have been limited.

A quantitative research