A Culturally Sensitive Intervention for African Americans with T2DM

Decreasing Diabetes in the African American Community Through Health Education

Despite aggressive public health awareness campaigns in recent years as well as intensive research concerning efficacious treatments, the prevalence of Type 2 diabetes mellitus (T2DM) continues to increase among the African American population in general and among black males in particular. In fact, more than 3 million African Americans currently suffer from T2DM and this population is twice as likely to experience severe complication such as lower extremity amputations, blindness and end-stage renal disease as a result of their disease compared to whites. Although every individual is unique, of course, there is growing recognition among public health educators that far too many African Americans fail to recognize the effects of lifestyle choices on the severity of this chronic disease. The purpose of this paper is to review a study by Collins-McNeil, J. et al. (2013) which sought to fill the knowledge gap concerning the ways in which individual lifestyles can exacerbate the problems that many African Americans suffering from T2DM and the challenges they typically experience in making lifestyle changes to better manage their disease. Following the review, the paper provides a summary of the study’s findings in the conclusion.

1. What was the purpose of the study?

In response to the sustained increase in the prevalence of T2DM among African American males, Collins-McNeil, J. et al. (2013) used a pilot study to evaluate the feasibility of using a 12-week diabetes self-management educational initiative in a church-based cultural targeted (CBCT) program setting designed for African American males in their middle and older ages.

2. What research methodology did the author(s) use?

The 12-week diabetes self-management educational initiative was piloted with a sample which is described next below. The researchers collected qualitative data using focus groups following the completion of the intervention. The researchers also collected quantitative data at baseline as well as again at 12 weeks at the conclusion of the programming. The CBCT intervention consisted of a healthy eating module consisting of education concerning optimal culturally sensitive diets for diabetic individuals, how to read labels, planning meals, maintaining food logs to identify opportunities for improvement, controlling dietary fats and counting carbohydrates. In addition, the intervention also provided guidance concerning stress management techniques, the importance of increased physical activity, coping skills and education about diabetes that were specifically targeted at middle age and older African American males.

3. Who was the sample?

The same for this pilot test was comprised of 12 African-American adults (10 women and two men) aged 35 to 68 years in urban churches located in the Southeastern US.

4. What data were collected and how?

The quantitative data for this mixed methods study were collected at baseline and at 12 weeks and included questionnaires and anthropometric measures. In addition, the researchers also collected qualitative data using a focus group. In addition, the researchers used a series of questionnaires and scales with demonstrated reliability and validity to collect physical activity level data, demographic information as well as stress, depression and anxiety levels among the respondents.

5. What analysis was conducted?

The quantitative data from the questionnaires and scales were analyzed using instrument-specific statistical analyses. The qualitative data the emerged from the post-intervention focus group was synthesized with the qualitative data analysis and relevant quotations from the focus group participants were reported verbatim.

6. What were the main findings?

The main findings that emerged from this study confirmed the feasibility of using a 12-week diabetes self-management educational initiative to improve self-care among African Americans with T2DM. In this regard, Collins-McNeil, J. et al. (2013) report that, “Interventions focused on diabetes self-management education, physical activity, behavioral management, and emotional regulation can be implemented in the community and can lead to improvements in self-care management, emotional distress and physical health in African-American adults with T2DM” (p. 7).

7. What were the strengths and weaknesses of the study?

The main strengths of this study included the use of culturally specific education as well as the use of questionnaires and scales with proven reliability and validity. The main weaknesses of this study included the relatively small number of subjects and the limitation to a specific region of the country, suggesting that the findings may not be fully generalizable for all African American populations in the United States.