title: A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial.
abstract: BACKGROUND
  The objective of this pilot 6-month randomized controlled trial was to determine the effectiveness of an intensive, community-based, group intervention that focused on diet, physical activity, and peer support for reducing weight among urban-dwelling African Americans with comorbid type 2 diabetes and hypertension.
  
  
  METHODS
  Sixty-one participants were randomized into an intervention or control group. The 6-month intervention consisted of 18 group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter. The intervention featured culturally tailored nutrition education, behavioral skills training, and social support focused on changes to diet and physical activity. The control group consisted of two 3-hour group sessions of diabetes self-management education taught by a community health worker. Outcome measures were assessed at baseline and 6 months. The primary outcome was achievement of a 5% weight reduction at 6 months. A secondary outcome was achievement of a 0.5 percentage-point reduction in hemoglobin A1c (HbA1c).
  
  
  RESULTS
  Groups did not differ in achievement of the weight-loss goal. Intervention participants lost a mean of 2.8 kg (P = .01); control participants did not lose a significant amount of weight. A greater proportion of intervention (50.0%) than control (21.4%) participants reduced HbA1c by 0.5 percentage points or more at 6 months (P = .03).
  
  
  CONCLUSIONS
  The intervention was more effective than usual care (short-term diabetes education) at improving glycemic control, but not weight, in low-income African Americans with comorbid diabetes and hypertension. A community-based 6-month group class with culturally tailored education, behavioral skills training, and peer support can lead to a clinically significant reduction in HbA1c.
authors.affiliation: Elizabeth B. Lynch, PhD, Department of Preventive Medicine, Rush University Medical Center, 1700 West Van Buren, Suite 470, Chicago, IL 60657. Telephone: 312-563-2254. E-mail: elizabeth_lynch@rush.edu.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Lynch
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Liebman
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ventrelle
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Avery
authors.affiliation: Rush University Medical Center, Chicago, Illinois, and Lake Forest College, Lake Forest, Illinois. Dr Lynch is also affiliated with Lake Forest College, Lake Forest, Illinois.
authors.forename: DeJuran
authors.initials: D
authors.lastname: Richardson
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D015992:Body Mass Index; D002641:Chicago / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D015444:Exercise / Q000523:psychology*; D005260:Female; D005518:Food Preferences / Q000208:ethnology / Q000523:psychology; D006442:Glycated Hemoglobin / Q000378:metabolism; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D052756:Nutritional Sciences / Q000193:education; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010865:Pilot Projects; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin