Outcomes of a Culturally Adapted Family Model of Diabetes Education and Support for Marshallese Persons With Type 2 Diabetes

Purpose: The purpose of this study is to evaluate a culturally adapted family model of a diabetes self-management education and support (DSMES) intervention (Family-DSMES) called Ājjmuurur Baamḷe DSMES among Marshallese persons living in the United States. Methods: Marshallese participants with type 2 diabetes mellitus (PWDs) in Washington state and Hawai‘i were enrolled in the Ājjmuurur Baamḷe DSMES intervention, which was delivered by community health workers in faith-based organizations (churches). Changes in A1C, self-reported diabetes-related knowledge and behaviors, and family support for management of type 2 diabetes mellitus (T2DM) were measured at baseline and postintervention. Results: A total of 337 participants were consented or assented and enrolled (164 PWDs and 173 family members). Two hundred seven (207) participants (110 PWDs and 97 family members) completed the Ājjmuurur Baamḷe DSMES and provided baseline and postintervention A1C data. PWDs saw significant reductions in their A1C and significant improvements in self-reported diabetes-related behavioral and psychosocial outcomes. Conclusions: Improvements in outcome measures support the use of Ājjmuurur Baamḷe DSMES in the Marshallese PWDs community. The findings also support the feasibility of collaboration with faith-based organizations such as churches for the delivery of DSMES. It further highlights the clinical efficacy of the delivery of diabetes health education by community health workers and supports family-based DSMES as an option for achieving value-based care and improvements in primary and secondary prevention of T2DM.