Culturally Tailored Intervention for Rural African Americans With Type 2 Diabetes

Abstract

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.

A Systematic Review: Family Support Integrated To Diabetes Self-Management among Glycemic Uncontrolled Type II DM Patients

“…We found that DSME based individual program was conducted into 40.9% of the studies (12,13,16,20,23,25,29,30,32) and 59.1% of the studies offered the DSME in a combination of individual and group education (12,14,15,17,20,21,27,31,32,34) . In general, The individual or group-based program provided the intervention of several strategies, including personalized counseling, feedback regarding goal-setting and problem-solving, support for self-care practice from family members, and the follow-up session.…”

“…Four studies used food model, picture, illustration, foot picture (14,18,20,24) . Diabetes handout/booklet (diet, exercise, medication, eye, and foot self-care) been used to spread the knowledge (15,16,19,21,30,32,36) . In addition, four studies (13,14,20,34) used video and DVD to show the successfully of self-care behaviors practice among diabetes patients.…”

“…(2010) (27) TobertDeborah (2011) (28) control trial (RCT) Utz (2008) (30) Randomized control trial (RCT) -Culturally relevant group DSME intervention was consisted of eight 2-hours education session over 8 weeks period, incorporated the activities and problem solving in each group session -DSME was delivered by emphasizing the supportive atmosphere, storytelling related to diabetes care, diabetes education material, lesson, an approach emphasizing respect and empowerment -Individual DSME session: week 1 is setting goal; week 4 is reviewing the progress, problem solving, offering additional information; and week 8; final review, discussion about the self-management achievement and plan for future self-care -Families were invited to selected group session to gain the diabetes information and peer support …”

Medical Advice, Diabetes Self-Management, and Health Outcomes of a Multi-Ethnic Population from the National Health and Nutrition Examination Survey 2007-2008

“…A pilot study comparing two culturally sensitive interventions: group DSME and individual DSME for African-Americans with type 2 diabetes showed statistical trends for improved goal attainment for those participants who attended group DSME (Utz, et al, 2008). The authors' premise was that social dynamics of an expert functioning within a group of peers would enhance the learning process for individuals beyond that of the expert and the individual (Utz et al, 2008).…”

“…The authors' premise was that social dynamics of an expert functioning within a group of peers would enhance the learning process for individuals beyond that of the expert and the individual (Utz et al, 2008).…”