A resilience intervention in African American adults with type 2 diabetes: a pilot study of efficacy.
The purpose of this pilot study was to determine the feasibility of offering the authors' Diabetes Coaching Program (DCP), adapted for African Americans, in a sample of African American adults with type 2 diabetes.



The study used a 1-group, pretest-posttest design to test the acceptance and potential effectiveness of the DCP. Subjects were a convenience sample of 16 African Americans (8 women, 8 men) with type 2 diabetes; 12 subjects (6 women, 6 men) completed the program. The DCP included 4 weekly class sessions devoted to resilience education and diabetes self-management, followed by 8 biweekly support group meetings. Psychosocial process variables (resilience, coping strategies, diabetes empowerment) and proximal (perceived stress, depressive symptoms, diabetes self-management) and distal outcomes (body mass index [BMI], fasting blood glucose, HbA1C, lipidemia, blood pressure) were assessed at baseline and at 6 months after study entry. Qualitative data were collected at 8 months via a focus group conducted to examine the acceptability of the DCP.



Preliminary paired t tests indicated statistically significant improvements in diabetes empowerment, diabetes self-management, BMI, HbA1c, total cholesterol, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure. Medium to large effect sizes were reported. Resilience, perceived stress, fasting blood glucose, and high-density lipoprotein cholesterol improved, but changes were not statistically significant. Focus group data confirmed that participants held positive opinions regarding the DCP and follow-up support group sessions, although they suggested an increase in program length from 4 to 8 weeks.



The pilot study documented the feasibility and potential effectiveness of the DCP to enhance diabetes empowerment, diabetes self-management, and reductions in the progression of obesity, type 2 diabetes, and cardiovascular disease in the African American community. Randomized experimental designs are needed to confirm these findings.
Steinhardt
Mary A
MA
The Department of Kinesiology and Health Education, University of Texas at Austin (Dr Steinhardt)
Mamerow
Madonna M
MM
Department of Human Ecology, College of Natural Sciences, University of Texas at Austin (Dr Mamerow)
Brown
Sharon A
SA
School of Nursing, University of Texas at Austin (Dr Brown)
Jolly
Christopher A
CA
Department of Human Ecology, College of Natural Sciences, University of Texas at Austin (Dr Jolly)
D044383:Black People / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011369:Professional-Patient Relations; D012201:Reward; D012648:Self Care; D012941:Social Responsibility; D014481:United States / Q000453:epidemiology; D001741:Black or African American