Diabetes Self-Management Education and Support Culturally Tailored for African Americans: COVID-19-Related Factors Influencing Restart of the TX STRIDE Study

Abstract

Purpose The purpose of this substudy was to determine the most acceptable way to restart the Texas Strength Through Resilience in Diabetes Education (TX STRIDE) study safely using remote technologies. Following the emergence of COVID-19, all in-person TX STRIDE intervention and data collection sessions were paused. Methods Qualitative descriptive methods using telephone interviews were conducted during the research pause. A structured interview guide was developed to facilitate data collection and coding. Forty-seven of 59 Cohort 1 participants were interviewed (mean age = 60.7 years; 79% female; mean time diagnosed with type 2 diabetes = 11 years). Results Data categories and subcategories were generated from the interview responses and included: personal experiences with COVID-19, effects of COVID-19 on diabetes self-management, psychosocial and financial effects of COVID-19, and recommendations for program restart. Although some participants lacked technological knowledge, they expressed eagerness to learn how to use remote meeting platforms to resume intervention and at-home data-collection sessions. Six months after the in-person intervention was paused, TX STRIDE restarted remotely with data collection and class sessions held via Zoom. A majority of participants (72.9%) transitioned to the virtual platform restart. Conclusions Qualitative findings guided the appropriate implementation of technology for the study, which facilitated a successful restart. High retention of participants through the study transition provides evidence that participants are invested in learning how to manage their diabetes despite the challenges and distractions imposed by COVID-19.

Feasibility and Performance of Hemoglobin A1C Self-Testing During COVID-19 Among African Americans With Type 2 Diabetes

“…When the TX STRIDE study resumed, the intervention was modified from the original in-person format to a remote format using a video conference platform (ie, Zoom). 17 Prior to the pandemic, A1C was measured in person using a laboratory-based testing device, the DCA Vantage™ Analyzer (DCA, Siemens Medical Solutions Diagnostics, Malvern, PA) with a reported capacity to measure A1C values that range from 2.5% to 14.0%. During the pandemic, however, the A1CNow was mailed and used to measure A1C remotely by participants at home with the assistance of research staff.…”

“…TX STRIDE is an NIH-funded longitudinal randomized controlled clinical trial to determine the efficacy of a resilience-based diabetes self-management education and support program culturally tailored for AA adults with T2D. 17 Soon after the intervention began, all in-person research activities were paused due to the COVID-19 pandemic. When the TX STRIDE study resumed, the intervention was modified from the original in-person format to a remote format using a video conference platform (ie, Zoom).…”

Exploring Technology Domains for Diabetes Care and Management under Pandemic: A preliminary scoping review

“…[31,32,33] (Table 1 and Figure 2). In glucose management (n=4) and insulin administration (n=2), three papers used implanted phone interviews or consultations [33,34,35].…”

The Association of Multidimensional Sleep Health With HbA1c and Depressive Symptoms in African American Adults With Type 2 Diabetes

“…The current study used baseline data ( N = 284) from TX STRIDE (Texas Strength Through Resilience in Diabetes Education), an ongoing clinical trial examining the effectiveness of a resilience-based diabetes self-management education and support program on diabetes-related health outcomes (31). Participants were recruited through local churches in Austin, TX, and the surrounding areas.…”