A Diabetes Management Program for African American Women With Type 2 Diabetes

Keyserllng, Thomas C.; Ammerman, Alice S.; Samuel‐Hodge, Carmen D.; Ingram, Allyson F; Skelly, Anne H.; Elasy, Tom A.; Johnston, Larry F.; Cole, Anne; Henriquez-Rolddn, Carlos F.

doi:10.1177/014572170002600508

Cited by 55 publications

(53 citation statements)

References 22 publications

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“…were recruited from seven primary care practices in central North Carolina to participate in a randomized controlled trial of a diet and physical activity intervention (21,22). To participate, patients had to be African-American women, Ն40 years of age, with type 2 diabetes (defined as diagnosis of diabetes at Ն20 years of age with no history of ketoacidosis).…”

Section: Research Design and Methods -Study Participantsmentioning

confidence: 99%

A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes

et al. 2004

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OBJECTIVE -This study assesses the validity of dietary data from African-American women with type 2 diabetes by comparing reported energy intake (EI) with total energy expenditure (TEE) estimated by an accelerometer and basal metabolic rate (BMR). RESEARCH DESIGN AND METHODS -EI of 200African-American women was assessed by three telephone-administered 24-h diet recalls using a multiple-pass approach. Physical activity was measured over a 7-day period by accelerometer, which also provided an estimate of TEE. Underreporting of EI was determined by using cutoffs for EI-to-TEE and EI-to-BMR ratios.RESULTS -Participants, on average, were 59 years of age, with a BMI of 35.7, 10.5 years of diagnosed diabetes, and 10.7 years of education. Mean EI was 1,299 kcal/day; mean EI-to-TEE and EI-to-BMR ratios were 0.65 and 0.88, respectively. Among the 185 subjects with complete dietary data, 81% (n ϭ 150) were classified as energy underreporters using the EI-to-TEE ratio cutoff; 58% (n ϭ 107) were classified as energy underreporters using the EI-to-BMR ratio. Energy underreporters had significantly lower reported fat, higher protein, but similar carbohydrate intakes compared with non-underreporters. The EI-to-TEE ratio was not significantly associated with any demographic variables or following a diet for diabetes, but it was inversely associated with BMI (r ϭ Ϫ0.37, P Ͻ 0.0001). In a multivariate model, demographic variables, BMI, and following a diet for diabetes explained 16% of the variance in the EI-to-TEE ratio, with the latter two variables being the only significant predictors (inversely associated). CONCLUSIONS -Widespread energy underreporting among this group of overweightAfrican-American women with type 2 diabetes severely compromised the validity of selfreported dietary data. Diabetes Care 27:663-669, 2004A ccurate estimates of dietary intake are important in interpreting the effects of dietary interventions on dietary behaviors and treatment outcomes. Because assessments of dietary intake are generally obtained by self-report, they are prone to a number of reporting biases, which may lead to misrepresentation of actual intake and compromise the validity of the data. There is ample evidence that underreporting energy intake (EI) is a common phenomenon associated with dietary assessments (1-3). However, the degree of underreporting varies greatly, from 10 to 91%, depending on several population characteristics and the method, definition, or cutoff value used to classify energy underreporters. The most commonly identified characteristics associated with energy underreporting are high BMI (4 -6), female sex (7-9), increased age (10 -12), and the desire to lower body weight (13-15). Only a few studies, however, focus specifically on African Americans (16) or individuals with type 2 diabetes (17).The purpose of this research was to assess the validity of diet self-reports in a sample of older African-American women with type 2 diabetes by comparing reported EI with total energy expenditure (TEE) and basal metabolic rat...

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Section: Research Design and Methods -Study Participantsmentioning

confidence: 99%

A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes

et al. 2004

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“…The categories for the PA intervention were moderate intensity (e.g., walking briskly, mopping, raking lawn), mild intensity (slow walking, stretching exercises), non-weight bearing activities (stretching exercises), or no PA. Study design and intervention. The design of this study, a description of the intervention, and baseline characteristics of participants has been published elsewhere (16). The intervention, "A New Leaf.…”

mentioning

confidence: 99%

“…Selection of the CDAs is described elsewhere (16); all were African-American women with type 2 diabetes. One CDA was recruited from each participating practice site and trained for her role in this study during four weekly 4-h sessions.…”

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confidence: 99%

A Randomized Trial of an Intervention to Improve Self-Care Behaviors of African-American Women With Type 2 Diabetes

et al. 2002

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OBJECTIVE -To determine whether a culturally appropriate clinic-and community-based intervention for African-American women with type 2 diabetes will increase moderate-intensity physical activity (PA).RESEARCH DESIGN AND METHODS -In this randomized controlled trial conducted at seven practices in central North Carolina, 200 African-American women, Ն40 years of age with type 2 diabetes, were randomized to one of three treatment conditions: clinic and community (group A), clinic only (group B), or minimal intervention (group C). The clinic-based intervention (groups A and B) consisted of four monthly visits with a nutritionist who provided counseling to enhance PA and dietary intake that was tailored to baseline practices and attitudes; the community-based intervention (group A) consisted of three group sessions and 12 monthly phone calls from a peer counselor and was designed to provide social support and reinforce behavior change goals; and the minimal intervention (group C) consisted of educational pamphlets mailed to participants. The primary study outcome was the comparison of PA levels between groups assessed at 6 and 12 months by accelerometer, which was worn while awake for 7 days.RESULTS -Totals of 175 (88%) and 167 (84%) participants completed PA assessment at 6 and 12 months, respectively. For comparison of PA, the P value for overall group effect was 0.014. Comparing group A with C, the difference in the average adjusted mean for PA was 44.1 kcal/day (95% CI 13.1-75.1, P ϭ 0.0055). Comparing group B with C, the difference in the average adjusted mean was 33.1 kcal/day (95% CI 3.3-62.8, P ϭ 0.029). The intervention was acceptable to participants: 88% were very satisfied with clinic-based counseling to enhance PA, and 86% indicated that the peer counselor's role in the program was important.CONCLUSIONS -The intervention was associated with a modest enhancement of PA and was acceptable to participants.

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“…Previous studies have shown that traditional diabetes education, which includes content on recommended dietary changes, has not been successful in AA communities Keyserling, Ammerman et al, 2000). It has also been argued that one of the keys to reducing racial and ethnic health disparities is with culturally competent health care .…”

Section: Complications Due To Diabetes Are Numerous and Costly Compamentioning

confidence: 99%

“…In a meta-analysis dietary interventions overall reduced weight by 20 pounds and A1C by 2.7%-age points, on average (Brown, Upchurch, Anding, Winter, & Ramirez, 1996). Secondly, the use of traditional diabetes education that includes modifications in diet and nutrition without reference to cultural influences has been ineffective for AAW Keyserling, Ammerman et al, 2000). It has been proposed that the reason for unsuccessful results with generic education for this population was because the interventions were not culturally tailored and, in some cases, conflicted with cultural values.…”

Section: Gaps In the Literaturementioning

confidence: 99%

Culture and Food Practices of African American Women With Type 2 Diabetes

Sumlin

Brown

2017

Diabetes Educ

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A Diabetes Management Program for African American Women With Type 2 Diabetes

Abstract: Participants found this program to be culturally relevant and acceptable. Its effects on diet, physical activity, and self-care behaviors will be assessed in a randomized trial.

Cited by 55 publications

References 22 publications

A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes

A Comparison of Self-Reported Energy Intake With Total Energy Expenditure Estimated by Accelerometer and Basal Metabolic Rate in African-American Women With Type 2 Diabetes

A Randomized Trial of an Intervention to Improve Self-Care Behaviors of African-American Women With Type 2 Diabetes

Culture and Food Practices of African American Women With Type 2 Diabetes

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