An Automated Telephone Nutrition Support System for Spanish-Speaking Patients With Diabetes

• Published in: Journal of diabetes science and technology Vol. 8; no. 6; pp. 1115 - 1120
• Main Authors: Khanna, Raman, Stoddard, Pamela J., Gonzales, Elizabeth N., Villagran-Flores, Mariana, Thomson, Joan, Bayard, Paul, Palos Lucio, Ana Gabriela, Schillinger, Dean, Bertozzi, Stefano, Gonzales, Ralph
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2014
• Subjects: Automation; Counseling - methods; Diabetes Mellitus, Type 2 - diet therapy; Diet Therapy - methods; Female; Glycated Hemoglobin A - analysis; Glycemic Index; Hispanic Americans; Humans; Male; Middle Aged; Nutritional Status; Original; Telemedicine - methods; Telephone; diabetes care; Spanish; telephone nutrition support; vulnerable populations; self-care
• ISSN: 1932-2968; 1932-2968; 1932-3107
• DOI: 10.1177/1932296814550186

Background: In the United States, Spanish-speaking patients with diabetes often receive inadequate dietary counseling. Providing language and culture-concordant dietary counseling on an ongoing basis is critical to diabetes self-care. Objective: To determine if automated telephone nutrition support (ATNS) counseling could help patients improve glycemic control by duplicating a successful pilot in Mexico in a Spanish-speaking population in Oakland, California. Design: A prospective randomized open-label trial with blinded endpoint assessment (PROBE) was performed. Participants: The participants were seventy-five adult patients with diabetes receiving care at a federally qualified health center in Oakland, California. Interventions: ATNS, a computerized system that dialed patients on their phones, prompted them in Spanish to enter (via keypad) portions consumed in the prior 24 hours of various cultural-specific dietary items, and then provided dietary feedback based on proportion of high versus low glycemic index foods consumed. The control group received the same ATNS phone calls 14 weeks after enrollment. Main Measures: The primary outcome was hemoglobin A1c % (A1c) 12 weeks following enrollment. Key Results: Participants had no significant improvement in A1c (–0.3% in the control arm, –0.1% in the intervention arm, P = .41 for any difference) or any secondary parameters. Conclusions: In our study, an ATNS system did not improve diabetes control in a Spanish-speaking population in Oakland.