Randomized trial of a literacy-sensitive, culturally tailored diabetes self-management intervention for low-income latinos.Diabetes Care 34

OBJECTIVE—To test whether a theory-based, literacy-tailored, and culturally tailored self-management intervention, Latinos en Control, improves glycemic control among low-income Latinos with type 2 diabetes. RESEARCH DESIGN AND METHODS—A total of 252 patients recruited from com-munity health centers were randomized to the Latinos en Control intervention or to usual care. The primarily group-based intervention consisted of 12 weekly and 8 monthly sessions and targeted knowledge, attitudes, and self-management behaviors. The primary outcome was HbA1c. Secondary outcomes included diet, physical activity, blood glucose self-monitoring, diabetes knowledge and self-efficacy, and other physiological factors (e.g., lipids, blood pressure, and weight). Measures were collected at baseline and at 4- and 12-month follow-up. Change in outcomes over time between the groups and the association between HbA1c and possible medi-ators were estimated using mixed-effects models and an intention-to-treat approach. RESULTS—A significant difference in HbA1c change between the groups was observed at 4 months (intervention 20.88 [21.15 to 20.60] versus control 20.35 [20.62 to 0.07], P, 0.01), although this difference decreased and lost statistical significance at 12 months (inter