Picture Good Health: A Church-Based Self-Management Intervention Among Latino Adults with Diabetes.
BACKGROUND
Churches may provide a familiar and accessible setting for chronic disease self-management education and social support for Latinos with diabetes.


OBJECTIVE
We assessed the impact of a multi-faceted church-based diabetes self-management intervention on diabetes outcomes among Latino adults.


METHODS
This was a community-based, randomized controlled, pilot study.


METHODS
One-hundred adults with self-reported diabetes from a Midwestern, urban, low-income Mexican-American neighborhood were included in the study.


METHODS
Intervention participants were enrolled in a church-based diabetes self-management program that included eight weekly group classes led by trained lay leaders. Enhanced usual care participants attended one 90-minute lecture on diabetes self-management at a local church.


METHODS
The primary outcome was change in glycosylated hemoglobin (A1C). Secondary outcomes included changes in low-density lipoproteins (LDL), blood pressure, weight, and diabetes self-care practices.


RESULTS
Participants' mean age was 54 ± 12 years, 81 % were female, 98 % were Latino, and 51 % were uninsured. At 3 months, study participants in both arms decreased their A1C from baseline (-0.32 %, 95 % confidence interval [CI]: -0.62, -0.02 %). The difference in change in A1C, LDL, blood pressure and weight from baseline to 3-month and 6-month follow-up was not statistically significant between the intervention and enhanced usual care groups. Intervention participants reported fewer days of consuming high fat foods in the previous week (-1.34, 95 % CI: -2.22, -0.46) and more days of participating in exercise (1.58, 95 % CI: 0.24, 2.92) compared to enhanced usual care from baseline to 6 months.


CONCLUSIONS
A pilot church-based diabetes self-management intervention did not reduce A1C, but resulted in decreased high fat food consumption and increased participation in exercise among low-income Latino adults with diabetes. Future church-based interventions may need to strengthen linkages to the healthcare system and provide continued support to participants to impact clinical outcomes.
Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, Chicago, IL, 60637, USA. abaig@uchicago.edu.
Arshiya A
AA
Baig
Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, Chicago, IL, 60637, USA.
Amanda
A
Benitez
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
Cara A
CA
Locklin
Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, Chicago, IL, 60637, USA.
Yue
Y
Gao
Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
Sang Mee
SM
Lee
Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, Chicago, IL, 60637, USA.
Michael T
MT
Quinn
Department of Pediatric Endocrinology, University of Illinois at Chicago, Chicago, IL, USA.
Marla C
MC
Solomon
Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Lisa
L
Sánchez-Johnsen
Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, Chicago, IL, 60637, USA.
Deborah L
DL
Burnet
Section of General Internal Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, Chicago, IL, 60637, USA.
Marshall H
MH
Chin
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002410:Catholicism; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000628:therapy*; D061345:Early Medical Intervention / Q000379:methods*; D015444:Exercise / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012648:Self Care / Q000379:methods*
CBPR; Latino; church-based intervention; diabetes