A church-based diabetes self-management education program for African Americans with type 2 diabetes.
BACKGROUND
Diabetes self-management education interventions in community gathering places have been moderately effective, but very few studies of intervention effectiveness have been conducted among African Americans with type 2 diabetes. This paper describes a church-based diabetes self-management education intervention for African Americans, a randomized controlled trial to evaluate the intervention, and baseline characteristics of study participants.


METHODS
A New DAWN: Diabetes Awareness & Wellness Network was conducted among 24 churches of varying size in North Carolina. Each church recruited congregants with type 2 diabetes and designated a diabetes advisor, or peer counselor, to be part of the intervention team. Participants were enrolled at each church and randomized as a unit to either the special intervention or the minimal intervention. The special intervention included one individual counseling visit, twelve group sessions, three postcard messages from the participant's diabetes care provider, and twelve monthly telephone calls from a diabetes advisor. Baseline data included measures of weight, hemoglobin A1c, blood pressure, physical activity, dietary and diabetes self-care practices, and psychosocial factors. The study to evaluate the intervention (from enrollment visit to last follow-up) began in February 2001 and ended in August 2003.


RESULTS
Twenty-four churches (with 201 total participants) were randomized. Sixty-four percent of the participants were women. On average, the participants were aged 59 years and sedentary. They had an average of 12 years of education, had been diagnosed with diabetes for 9 years, had a body mass index of 35, had a hemoglobin A1c level of 7.8%, and had a reported dietary intake of 39% of calories from fat.


CONCLUSIONS
A New DAWN is a culturally sensitive, church-based diabetes self-management education program for African Americans with type 2 diabetes that is being evaluated for effectiveness in a randomized controlled trial. The outcomes of A New DAWN will contribute to the literature on community-based interventions for minority populations and help to inform the selection of approaches to improve diabetes care in this population.
Samuel-Hodge
Carmen D
CD
University of North Carolina at Chapel Hill, Department of Nutrition, Schools of Medicine and Public Health, CB #7426, 1700 Airport Rd, Room 246, Chapel Hill, NC 27599-8140, USA. carmen_samuel@unc.edu
Keyserling
Thomas C
TC
France
Renaé
R
Ingram
Allyson F
AF
Johnston
Larry F
LF
Pullen Davis
Lisa
L
Davis
Gwen
G
Cole
Anne S
AS
D001741:Black or African American / Q000193:education*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010353:Patient Education as Topic / Q000458:organization & administration*; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods* / Q000523:psychology