An Empowerment Approach for Elders Living With Diabetes: A Pilot Study of a Community-Based Self-Help Group—The Diabetes Club

ABSTRACT

Diabetes mellitus is a disabling, deadly disease, affecting one in five of adults over 65. Unfortunately, for the few elders that receive diabetes self-care training it is often taught using traditional didactic methods that are insensitive to their unique needs and immersed in the traditional medical paradigm. Integrating diabetes self-care into daily living demands more than knowledge acquisition and skill mastery; it requires acceptance of the disease, motivation for change, instrumental and emotional support, general problem-solving skills, and control over one's life – empowerment. This project sought to develop and pilot-test a peer-led, community-based, self-help intervention for elders with diabetes—the Diabetes Club. The intervention targeted diabetes self-efficacy, seeking to empower elders then increase diabetes self-care behavior targets, resulting in improved glycemic control. Club members and social workers collectively developed, implemented, tested intervention protocols, detailed in this paper with additional materials available on a dedicated website. Albeit over a short time period, findings showed significant improvements in diabetes self-efficacy, self-care behaviors, and reduction of glycosolated hemoglobin (A1C). The results are promising, demonstrating the benefits of social-work involvement in diabetes and the potential of elders helping themselves and each other.     

Intervention Provided to Linguistically Diverse Middle School Students with Severe Reading Difficulties

This study investigated the effectiveness of a multicomponent reading intervention implemented with middle school students with severe reading difficulties, all of whom had received remedial and/or special education for several years with minimal response to intervention. Participants were 38 students in grades 6-8 who had severe deficits in word reading, reading fluency, and reading comprehension. Most were Spanish-speaking English language learners (ELLs) with identified disabilities. Nearly all demonstrated severely limited oral vocabularies in English and, for ELLs, in both English and Spanish. Students were randomly assigned to receive the research intervention (n = 20) or typical instruction provided in their school's remedial reading or special education classes (n = 18). Students in the treatment group received daily explicit and systematic small-group intervention for 40 minutes over 13 weeks, consisting of a modified version of a phonics-based remedial program augmented with English as a Second Language practices and instruction in vocabulary, fluency, and comprehension strategies. Results indicated that treatment students did not demonstrate significantly higher outcomes in word recognition, comprehension, or fluency than students who received the school's typical instruction and that neither group demonstrated significant growth over the course of the study. Significant correlations were found between scores on teachers' ratings of students' social skills and problem behaviors and posttest decoding and spelling scores, and between English oral vocabulary scores and scores in word identification and comprehension. The researchers hypothesize that middle school students with the most severe reading difficulties, particularly those who are ELLs and those with limited oral vocabularies, may require intervention of considerably greater intensity than that provided in this study. Further research directly addressing features of effective remediation for these students is needed.     

A synthesis of read-aloud interventions on early reading outcomes among preschool through third graders at risk for reading difficulties

A synthesis and meta-analysis of the extant research on the effects of storybook read-aloud interventions for children at risk for reading difficulties ages 3 to 8 is provided. A total of 29 studies met criteria for the synthesis, with 18 studies providing sufficient data for inclusion in the meta-analysis. Read-aloud instruction has been examined using dialogic reading; repeated reading of stories; story reading with limited questioning before, during, and/or after reading; computer-assisted story reading; and story reading with extended vocabulary activities. Significant, positive effects on children's language, phonological awareness, print concepts, comprehension, and vocabulary outcomes were found. Despite the positive effects for read-aloud interventions, only a small amount of outcome variance was accounted for by intervention type.