8 results on '"AMBER DECKARD"'
Search Results
2. 910-P: Effectiveness of Randomized Controlled Trials to Improve A1C in Hispanic Populations with Type 2 Diabetes: A Systematic Review and Meta-analysis
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SOFIA URANGA, LAURA BIANCO, AMBER DECKARD, WEN WAN, JASON ALEXANDER, ERIN M. STAAB, ALEX W. RODRIGUEZ, RAJ SHETTY, and NEDA LAITEERAPONG
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
Objective: In the US, Hispanic persons have a higher rate of Type 2 diabetes (T2D) than the national average, as well as experience more diabetes-related complications than non-Hispanic whites (NHWs) . This increased prevalence can be attributed to social and biological factors, like access to care and increased predisposition to pre-diabetic conditions. Currently, limited evidence exists for the effectiveness of randomized controlled trials (RCTs) at improving A1C levels in this population with T2D. Methods: A systematic search focused on T2D interventions published from 1985 to 20was conducted using PubMed, Scopus, PsycInfo, and CINAHL. Search terms were structured around five broad concepts: diabetes, study design, language, race/ethnicity, and disparities. We focused on non-pharmacologic interventions, and included RCTs with ≥18.5% Hispanic persons, utilizing the 2020 US Census as standard. A random effects meta-analysis was performed to calculate the pooled effect size to provide summary estimates. Results: Of the 111,289 articles reviewed, 28 trials met inclusion criteria. Participants were 90% Hispanic and 70% female with a mean age of 55.8 years. Most interventions used cultural tailoring, lifestyle and behavioral changes, or telehealth support and included bilingual nurses, Spanish educational materials, or community health workers. Compared to control, these interventions were associated with a 0.19% (95% confidence interval: -0.39% to 0.01%; p Conclusion: This meta-analysis examined non-pharmacologic interventions in Hispanic persons with T2D and found that they reduced A1c to a small degree. This finding is important for future T2D interventions tailoring to this population, as well as future health policy. Future analyses will examine which type of interventions (i.e. individual, community, societal, or multi-level) are most successful at reducing A1c among Hispanic persons. Disclosure S.Uranga: None. L.Bianco: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.
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- 2022
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3. 924-P: Effectiveness of Interventions to Improve Hemoglobin A1c among Black Persons with Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Controlled Trials
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FAWSIA OSMAN, CHERRY JIANG, AMBER DECKARD, WEN WAN, JASON ALEXANDER, ERIN M. STAAB, ALEX W. RODRIGUEZ, RAJ SHETTY, and NEDA LAITEERAPONG
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
Background: The prevalence of Type 2 diabetes (T2D) is high among non-Hispanic Black persons. This population also has a high rate of poorly controlled T2D and a high burden of T2D related complications. To address this, various interventions have been studied to improve glycemic control. We performed a meta-analysis of published interventions on Black persons with T2D and their effects on HbA1c outcomes. Methods: An electronic search of literature in PubMed, Scopus, CINAHL, PsycINFO, and Medline was conducted from 1985 to 20for studies evaluating T2D interventions among predominantly minority populations. This analysis was limited to non-pharmacologic randomized controlled trials (RCTs) and studies that had an average ≥12.5% of total participants identifying as Black, utilizing the 2020 US Census as standard. Interventions were aimed at improving outcomes including blood pressure, weight, and lipids. For this analysis, we focused on the outcome HbA1c and its differences between experimental and control groups. A random effects meta-analysis was performed to calculate the pooled effect size of the various outcomes. Results: For this analysis, 35 RCTs were included (n=6467) . The participants were 61% Black and 65% female with a mean age of 56 years. Interventions included interdisciplinary T2D management, telehealth-based support, lifestyle focused programs, and peer support programs. There was a statistically significant reduction in HbA1c in the experimental group when compared to the control group (-0.17, 95% CI -0.28 to -0.06, p Conclusion: This meta-analysis found non-pharmacologic interventions were effective in reducing HbA1c among Black persons to a small degree. Future research is needed to estimate the effects of the level of intervention (i.e. individual, community, societal, or multi-level) in reducing HbA1c among this population to inform future public health programming and policy. Disclosure F.Osman: None. C.Jiang: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. E.M.Staab: None. A.W.Rodriguez: None. R.Shetty: None. N.Laiteerapong: None.
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- 2022
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4. 886-P: Development and Validation of the Diabetes Outcome Model for the U.S. (DOMUS)
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AARON N. WINN, ELBERT HUANG, PHILIP CLARKE, ANDREW J. KARTER, WEN WAN, DONALD R. MILLER, MELISSA FRANCO, AMBER DECKARD, and NEDA LAITEERAPONG
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
Purpose: The purpose of this study is to develop a diabetes outcomes model for the US (DOMUS) using a multi-ethnic, real-world-data cohort of newly diagnosed Type II diabetics that can predict outcomes for a U.S. multi-ethnic type 2 diabetes population. Methods: The Kaiser Permanente Northern California (KPNC) Diabetes Registry, which is a well-described epidemiologic cohort with up to 13 years of follow-up from EMR and claims, were used to identify over 150,000 newly diagnosed diabetes patients between 2005-2016 with up to 13-year follow-up. The DOMUS model integrates separate, but interdependent risk equations to predict events for each of the micro and macro-vascular events, hypoglycemia, dementia, depression, and death, and predictive models for eight biomarker levels. Model accounted for static demographic factors (e.g., race) , neighborhood deprivation, and dynamic factors, such as age, duration of diabetes, fifteen-possible glucose -lowering treatment combinations, biomarker levels, and history of diabetes-related events. Moreover, the models explicitly allow for a legacy effect (average A1c in the first year after diagnosis) for all outcomes. Results: Data were randomly split into 75,000, 18,750, and 18,750 patients to perform estimation, out-of-sample calibration, and validation respectively. Model predictions in the validation sample closely aligned with the observed longitudinal trajectory of biomarkers and outcomes. Moreover, we examine the model performance within by age, race/ethnicity, and sex and found excellent predictive performance within subgroups. Conclusion: The DOMUS Model is able to simulate event histories and biomarker trajectories that closely match observed outcomes in a real-world, multi-ethnic population of newly diagnosed diabetics. DOMUS has the potential to carry out many complex analyses that examine the effectiveness and cost-effectiveness of new medications, value of diabetes prevention, and serve as decision support tools in health care settings. Disclosure A.N.Winn: Consultant; Takeda Pharmaceutical Company Limited. E.Huang: Advisory Panel; Twin Health, Stock/Shareholder; AbbVie Inc. P.Clarke: None. A.J.Karter: Research Support; Dexcom, Inc. W.Wan: n/a. D.R.Miller: None. M.Franco: None. A.Deckard: None. N.Laiteerapong: None.
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- 2022
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5. 132-LB: Effectiveness of Interventions to Improve Cardiovascular Risk Factors in U.S. Asian Persons with Type 2 Diabetes—A Systematic Review and Meta-analysis
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JASON XIAO, JIELU YU, AMBER DECKARD, WEN WAN, ERIN M. STAAB, ALEX W. RODRIGUEZ, RAJ SHETTY, and NEDA LAITEERAPONG
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
Objective: Asian persons have an increased risk of type 2 diabetes (T2D) compared to non-Hispanic white persons, with approximately two in five individuals being diagnosed. The prevalence of T2D among this population has grown in recent years as Asian persons are the fastest growing racial/ethnic group in the US. We conducted a meta-analysis of US randomized controlled trials (RCTs) to evaluate the effectiveness of T2D interventions at improving systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and HbA1c among this population. Methods: An electronic search of literature in PubMed, Scopus, CINAHL, PsycINFO, and Medline was conducted from 1985 to 2019 for studies evaluating T2D interventions among predominantly minority populations. This analysis was limited to RCTs with an average >6% of total participants identifying as Asian, utilizing the 2020 US Census as standard. Interventions focusing on the efficacy of a drug, device, diet, surgery, or procedure were excluded. A random effects meta-analysis was performed to calculate the pooled effect size of the various outcomes. Results: Of the articles reviewed, 9 met inclusion criteria. All 9 included HbA1c and 5 included SBP/DBP. Participants were 62.8% Asian and 40.3% female with a mean age of 53.4 years. Interventions included diabetes education programs, utilization of community health workers, bilingual counseling, and cognitive therapy. There was a 0.36% decrease in HbA1c in the experimental group when compared to the control group (95% CI -0.48 to -0.25, p=0.80, I2=0%) . Compared to control, these interventions had minimal effects on SBP (-0.08, 95% CI -0.22 to 0.07, p=0.73, I2=0%) and DBP (0.01, 95% CI -0.22 to 0.25, p=0.23, I2=29%) . Conclusion: This meta-analysis found that RCTs for T2D in Asian persons modestly lowered HbA1c, with minimal impact on SBP/DBP. Future analysis should include observational studies to evaluate a larger sample and investigate their impact on other markers of health, as well as characterize these effects by level of intervention to inform health policy. Disclosure J. Xiao: None. J. Yu: None. A. Deckard: None. W. Wan: n/a. E. M. Staab: None. A. W. Rodriguez: None. R. Shetty: None. N. Laiteerapong: None.
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- 2022
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6. 171-OR: Effect of Interventions on Blood Pressure for Black Persons with Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Controlled Trials
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CHERRY JIANG, FAWSIA OSMAN, AMBER DECKARD, WEN WAN, JASON ALEXANDER, RAJ SHETTY, ERIN M. STAAB, and NEDA LAITEERAPONG
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
Background: Uncontrolled blood pressure (BP) is a major cardiovascular disease (CVD) risk factor, and CVD is the leading cause of death among non-Hispanic Black persons with type 2 diabetes (T2D) . While many interventions have been designed to improve BP control in this population, disparities persist. A meta-analysis of randomized controlled trials was conducted to evaluate the effectiveness of T2D interventions at improving BP. Methods: An electronic search of Medline, PubMed, Scopus, CINAHL, and PsychINFO was conducted from 1985 to 2019. Keywords included those related to diabetes, study design and race/ethnicity. We included non-pharmacologic trials with ≥12.5% Black persons (using the 2020 US Census as a standard) . Interventions were aimed at improving outcomes including HbA1c, BP, weight and lipids. For this analysis, we focused on the outcomes mean systolic (SBP) and diastolic blood pressure (DBP) differences between control and experimental groups. A random effects meta-analysis was performed to calculate the pooled effect size to provide summary estimates. Results: Sixteen trials (n=2314) reported SBP and DBP outcomes; two additional trials (total n=2919) reported only SBP outcomes. The participants were 59% Black and 71% female with a mean age of 55.9 years. Average baseline BP was similar for the control and intervention groups (134/78 and 134/77, respectively) . Interventions included self-management education, telehealth support, lifestyle programs, and pharmacist-led support. Compared to control, these interventions demonstrated no difference in SBP (0.01, 95% CI -0.to 0.mmHg, p=0.55, I2=0%) or DBP (-0.05, 95% CI -0.15 to 0.mmHg, p=0.20, I2=22%) . Conclusion: In this meta-analysis of trials aimed to improve outcomes in Black patients with T2D, there was no improvement in BP control. Given the high risk of CVD in this population, more effective interventions are needed to improve BP control in Black persons with T2D. Disclosure C.Jiang: None. F.Osman: None. A.Deckard: None. W.Wan: n/a. J.Alexander: None. R.Shetty: None. E.M.Staab: None. N.Laiteerapong: None.
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- 2022
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7. 927-P: The Impact of Community Health Worker Interventions on A1C in People of Racial/Ethnic Minority Groups with Type 2 Diabetes: A Systematic Review and Meta-analysis
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RAJ SHETTY, AMBER DECKARD, WEN WAN, AVIVA NATHAN, ERIN M. STAAB, ALEX W. RODRIGUEZ, ASHISH GANDHI, ARSHIYA A. BAIG, and NEDA LAITEERAPONG
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Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
Objective: Communities of racial/ethnic minority groups experience a higher prevalence of type 2 diabetes (T2DM) with higher rates of diabetes-related complications compared to non-Hispanic Whites. Interventions that utilize community health workers (CHW) are often successful at improving glycemic control. This analysis aimed to examine the effectiveness of CHW interventions on glycemic control in people of racial/ethnic minority groups with T2DM. Methods: A search of electronic databases (PubMed, Scopus, CINAHL, PsycInfo) to identify articles published between 1985 and 20was conducted using broad search terms for diabetes, race/ethnicity, and disparities. To further refine articles to those focusing on CHW-based randomized controlled trials, abstracts were searched for “community workers” and “promotores.” A random effects model was used to calculate the effect of CHW interventions on hemoglobin A1c (HbA1c) with future plans to analyze effects on other cardiovascular risk factors such as body mass index, blood pressure, and cholesterol. Results: A total of 22 RCTs were identified, involving 4996 adults (26% Black, 50% Hispanic, 11% Asian, and 11% Pacific Islander) . CHW interventions among people of racial/ethnic minority groups was associated with a 0.44% (95% confidence interval: -0.56% to -0.31%; p Conclusion: CHW interventions are an effective means to lower HbA1c among people of racial/ethnic minority groups with T2DM. This finding is important for future healthcare policies, which should work to emphasize culturally sensitive interventions for patients with T2DM while maintaining cost effectiveness through CHWs. Future research should examine the effectiveness of CHWs for diabetes prevention. Disclosure R.Shetty: None. A.Deckard: None. W.Wan: n/a. A.Nathan: None. E.M.Staab: None. A.W.Rodriguez: None. A.Gandhi: None. A.A.Baig: None. N.Laiteerapong: None.
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- 2022
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8. The Effect of Knowledge, Behaviors, and Attitudes Towards Dietary Fatty Acids on Blood Lipid Levels
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Amber Deckard
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Research design ,Correlation ,Animal fat ,Current consumption ,business.industry ,Blood cholesterol ,Blood lipids ,Physiology ,Medicine ,Significant negative correlation ,business ,Nutrition knowledge - Abstract
Research has shown a strong relationship between dietary fatty acids (FAs) and their impact on blood cholesterol. Few studies have examined knowledge, behaviors and attitudes (KBA) towards dietary FAs impact blood lipid levels. The objective of this project was to determine: 1) KBA of FAs using the modified General Nutrition Knowledge Questionnaire (GNKQ); and 2) correlations between anthropometric data, GNKQ responses, and blood lipid levels. This study utilized across-sectional research design in which 104 women ages 18-40 consented and completed the modified GNKQ via Qualtrics®. The GNKQ consisted of 70 questions. Additionally, a subset of nine women also were instructed to fast for 12-15 hours prior to testing at the Obesity Prevention Laboratory at TCU. Height (cm), weight (kg), BMI (kg/m2), waist-to-hip ratio were recorded. Next, a fasting blood sample (5mL) was obtained. The blood samples were sent to AnyLabTestNow® (Fort Worth, Texas) for a lipid panel. Results were then analyzed via IBM SPSS® (Statistics Version 25.0. Armonk, NY). Significance was set at p
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- 2019
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