The effect of a diabetes self-management program for African Americans in a faith-based setting

Diabetes is a lifelong chronic disease that requires daily management. Diabetes is the leading cause of blindness, kidney failure, and non-traumatic lower limb amputations. African Americans are more likely to suffer from diabetes related complications than any other race. The purpose of this study was to test a six-week culturally tailored diabetes self-management program for African Americans. The diabetes self-management intervention was conceptualized as the foundation that supported the changes in diabetes knowledge, self-efficacy, symptom management, and self-management activities. Thus, the specific aim of this study was to increase knowledge about diabetes, self-efficacy, symptom management, and self-management activities in African American adults diagnosed with diabetes. A one-group pre- and post-test was the design used in this study. The six-week intervention focused on areas of diabetes self-management based on the American Diabetes Association (ADA) guidelines: (a) introduction to diabetes, (b) healthy eating, (c) being active, (d), medications, (e) glucose monitoring and complications, and (f) symptom management. An African American nurse led the intervention. Adult African Americans with diabetes who were age 18 years old and older were recruited from two predominantly black churches in the south-eastern part of the United States. Sessions were held at each church directly after the morning and evening worship services. A total of 32 participants were recruited and 28 participants completed the six-week program. Health history and biomarkers (BMI, HBA1C) were measured at baseline. The major concepts were measured at baseline and post intervention using the Spoken Knowledge in Low Literacy Diabetes (SKILLD) scale, Diabetes Empower Scale- Short Form (DES-SF), Diabetes Symptom Checklist- Revised (DSC-r) scale, and the Summary of Diabetes Self-Care Activities (SDSCA) scale. At baseline, many person had low diabetes knowledge, self-efficacy, symptom management, and diabetes self-management activities. Findings revealed statistically significant positive improvements in diabetes knowledge, self-efficacy, symptoms management, and diabetes self-management activities from pre-intervention to post- intervention. Study participants gained an awareness of the need or diabetes self-management education. Designing and implementing culturally tailored diabetes self-management programs in faith-based settings are practical and necessary to reduce the disparity in diabetes for African Americans. More diabetes self-management studies are needed that target, recruit, and retain an adequate representation of African Americans. Also, more research is needed regarding African American cultures and learning styles so that programs can modify learning objectives to meet their needs