Purpose
The purpose of this pilot study was to evaluate a culturally tailored intervention for rural African Americans. Social Cognitive Theory provided the framework for the study.
Methods
Twenty-two participants were recruited and randomly assigned to either Group or Individual diabetes self-management (DSME). Group DSME included storytelling, hands-on activities, and problem-solving exercises. Individual DSME sessions focused on goal-setting and problem-solving strategies. Sessions were offered in an accessible community center over a 10-week period.
Results
Outcomes included glycosylated hemoglobin (A1C), self-care actions, self-efficacy level, goal attainment, and satisfaction with DSME. Participants in both Group and Individual DSME improved slightly over the 3-month period in self-care activities, A1C level, and goal attainment. Although differences were not statistically significant, trends indicate improved scores on dietary actions, foot care, goal attainment, and empowerment for those experiencing Group DSME.
Conclusions
The culturally tailored approach was well received by all participants. Improvements among those receiving Individual DSME may indicate that brief sessions using a culturally tailored approach could enhance self-care and glycemic control. Additional testing among more participants over a longer time period is recommended.
These findings confirm that family and peers greatly influence diabetes management among rural African Americans. The study's results will help health care providers understand the importance of involving family members and friends in the treatment and diabetes management of individuals with type 2 diabetes, particularly within rural African American communities where resources are limited.
The model described has the capacity to generate collaborations across denominational, racial, and class barriers, and has the potential of helping to unify the religious community around the important task of promoting successful aging.
Integrative health coaching (IHC) offers significant health improvement in biometric measures without pharmaceuticals. In this case of newly diagnosed impaired glucose tolerance (IGT) with obesity, IHC used the patient's strengths to reverse IGT, prevent frank diabetes, and reduce weight by 40 lbs or 21% of her original weight. This intervention included a client self-assessment and 14 in-person health coaching sessions over 11 months. IHC provides a framework to accomplish short-term goals and identify and overcome barriers while drawing on the strengths and aims of the individual.
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