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Presenter: Emily Haltiwanger, OTD, MHE, OTR, University of Texas at El Paso

A pilot study to investigate the improvement in adherence behaviors of type 2 English- speaking Mexican-American elderly diabetics, through participation in a culturally-appropriate support group mentoring system

Author: Emily Haltiwanger

Background: 
(Bandura Social Cognitive Theory) The Bridges Support Group Manual (similar to the Alcoholics Anonymous Big Book) and Mentoring System were developed because diabetics need support during adaptation to the chronic disease.  A self-sustaining "drop in peer model" was needed as an alternative to staff-led groups, to empower adaptation of elderly diabetics that are battling a lifetime of habitual behavioral patterns requiring change. The program provided structure for expression of feelings, positive role modeling and vicarious learning. This small funded pilot study asked: Will the Bridges Support Group Mentoring program provide a self-sustaining system to improve adherence behaviors of Type 2 diabetics in Mexican-American elderly?

Method:
Quasi-experimental design using subjects as their own controls:  Adherent subjects (mentors) experienced the support group program and were trained to lead support groups of mentees (non-adherent diabetics). Chi-squared tests were used to determine mean values between pretest and 3 posttests of both groups. Tests were the Glycosolated Hemoglobin A1C, and four questionnaires. Sample size: 16.

Results:
Results were significant at the p>.001 levels through p>.05. Each subject altered their behavior including such changes as increased frequency of exercise, increased adherence to dietary restrictions, increased frequency of testing and recording blood sugar results, and carrying of sugar sources and blood sugar meters at all times, on measures of self-efficacy, adaptiveness intrusiveness and transtheoretical change. Mentors demonstrated program sustainability by planning open community meetings beginning in October 2006, independently of the PI.

Conclusions:
This study will move into Year 2 funding with an experimental design for Spanish-speaking Mexican-American elderly diabetics. The future intent is to demonstrate effectiveness of self-sustaining support groups, as with the Alcoholics Anonymous model, across types of diabetes and age barriers.  Eventually, this peer-led model could provide structure for other chronic diseases, as AA has done for over 150 addictions.