1
|
Collette T, Stevens L, Robinson-Dooley V, Sterling E. COVID-19 Related Knowledge, Attitudes, and Behaviors Among Black Men with Chronic Health Conditions: A Latent Profile Analysis. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:734-749. [PMID: 39068542 PMCID: PMC11408096 DOI: 10.1080/19371918.2024.2381621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Research indicates that Black communities experienced disproportionately higher numbers of confirmed cases and fatalities throughout the COVID-19 pandemic with Black men experiencing marked reductions in life expectancy. Inequities were further magnified by known COVID-19 such as hypertension, diabetes, obesity, and higher prevalence of cardiovascular disease. The current project aimed to assess the knowledge, attitudes, and behaviors related to COVID-19 among Black men with chronic conditions. Specifically, we sought to determine whether COVID-19-related perspectives and behaviors impacted cross-sectional health outcomes. A national sample of Black men (N = 312) who self-reported at least one chronic disease responded to survey questions about their knowledge, attitude, and preventative behaviors (KAP) related to COVID-19. Analyses suggest that unique latent profiles based on COVID-19-related KAP differentially impacted participants' self-reported health and well-being for those low on KAP items. The discussion includes considerations on viral hygiene interventions, misinformation, stigma, and perceptions of discrimination.
Collapse
Affiliation(s)
- Tyler Collette
- Department of Psychological Science, Kennesaw State University, Kennesaw, Georgia, USA
| | - Laura Stevens
- School of Social Work, Simmons University, Boston, Massachusetts, USA
| | | | - Evelina Sterling
- Department of Sociology & Criminal Justice, Kennesaw State University, Kennesaw, Georgia, USA
| |
Collapse
|
2
|
Hawkins J, Sengupta S, Kloss K, Kurnick K, Ewen A, Nwawkwo R, Funnell M, Mitchell J, Jones L, Piatt G. Michigan men's diabetes project II: Protocol for peer-led diabetes self-management education and long-term support in Black men. PLoS One 2023; 18:e0277733. [PMID: 36862648 PMCID: PMC9980828 DOI: 10.1371/journal.pone.0277733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Previous literature has indicated that Black men are twice as likely to develop type 2 diabetes compared to their non-Hispanic White counterparts and are also more likely to have associated complications. Furthermore, Black men have lower access to quality health care, and masculinity norms have been shown to hinder them from seeking the limited care that is available. In this study, we aim to investigate the effect of peer-led diabetes self-management education and long-term ongoing support on glycemic management. The first phase of our study will consist of modification of existing diabetes education content to be more appropriate for the population of interest, Then, in the second phase, we will conduct a randomized controlled trial to test the intervention. Participants randomized to the intervention arm will receive diabetes self-management education, structured diabetes self-management support, and a more flexible ongoing support period. Participants randomized to the control arm will receive diabetes self-management education. Diabetes self-management education will be taught by certified diabetes care and education specialists, while the diabetes self-management support and ongoing support period will be facilitated by fellow Black men with diabetes who will be trained in group facilitation, patient-provider communication strategies, and empowerment techniques. The third phase of this study will consist of post-intervention interviews and dissemination of findings to the academic community. The primary goal of our study is to determine whether long-term peer-led support groups in conjunction with diabetes self-management education are a promising solution to improve self-management behaviors and decrease A1C levels. We will also evaluate the retention of participants throughout the study, which has historically been an issue in clinical studies focused on the Black male population. Finally, the results from this trial will determine whether we can proceed to a fully-powered R01 trial or if other modifications of the intervention are necessary. Trial registration: Registered at ClinicalTrials.gov with an ID of NCT05370781 on May 12, 2022.
Collapse
Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Srijani Sengupta
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Katherine Kloss
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Katie Kurnick
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Alana Ewen
- School of Public Health, University of Maryland, College Park, MD, United States of America
| | - Robin Nwawkwo
- Medical School, University of Michigan, Ann Arbor, MI, United States of America
| | - Martha Funnell
- Medical School, University of Michigan, Ann Arbor, MI, United States of America
| | - Jamie Mitchell
- School of Social Work, University of Michigan, Ann Arbor, MI, United States of America
| | - Lenette Jones
- School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
| | - Gretchen Piatt
- Medical School, University of Michigan, Ann Arbor, MI, United States of America
| |
Collapse
|
3
|
Tseng HK, Nkimbeng M, Han H. Gender differences in psychosocial characteristics and diabetes self-management among inner-city African Americans. Nurs Open 2022; 9:2425-2433. [PMID: 35616066 PMCID: PMC9374402 DOI: 10.1002/nop2.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/17/2022] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
AIMS To characterize differences in psychosocial variables between inner-city African American men and women with type 2 diabetes, and to test if the relationships between psychosocial variables and diabetes self-management behaviours differ by gender. DESIGN Secondary analysis. METHODS We used baseline data from participants enrolled in the Prevention through Lifestyle Intervention and Numeracy 4 Success-Diabetes study (N = 37). Differences in psychosocial variables between genders were compared using chi-square tests. A two-way analysis of variance was then used to compare self-management scores by different psychosocial characteristics and gender. RESULTS There was no statistically significant difference in psychosocial characteristics between genders. High diabetes knowledge and self-efficacy were associated with better self-management behaviours in African American women but not in men. In contrast, high numeracy was associated with better diabetes self-management only in men. Low depression, high health literacy, and high social support were associated with better self-management practices in both genders.
Collapse
Affiliation(s)
| | - Manka Nkimbeng
- School of NursingThe Johns Hopkins UniversityBaltimoreMarylandUSA
- School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Hae‐Ra Han
- School of NursingThe Johns Hopkins UniversityBaltimoreMarylandUSA
- Center for Cardiovascular and Chronic CareThe Johns Hopkins UniversityBaltimoreMarylandUSA
- Center for Community Programs, Innovation and ScholarshipThe Johns Hopkins UniversityBaltimoreMarylandUSA
| |
Collapse
|
4
|
Gamboa CJ, Julion WA. Caring in the recruitment of older African American adults with chronic health disease: An integrative review. Chronic Illn 2021; 17:323-346. [PMID: 32098480 DOI: 10.1177/1742395320905666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this integrative review is to accrue a comprehensive understanding of caring behavioral characteristics in the recruitment of older African-American adults into health-related research studies centered on chronic diseases. METHODS Combined methodologies, Whittemore & Knafl and Kable, Pich & Maslin-Prothero in accordance with preferred items for systematic reviews and meta-analysis, were used to guide the data collection and to report the findings. The data were analyzed based upon recruitment categorization and Kristen Swanson's middle-range theory of caring. RESULTS Ten out of 260 publications comprised the final sample. They were analyzed and then aggregated by chronic illnesses, recruitment activities, contact level, and Swanson's five caring behavioral concepts. Select cancers, diabetes, hypertension, and Alzheimer's disease were the chronic illness foci of eight publications. Cardiovascular disease and stroke were the focus of two publications. Only three studies utilized all five Swanson's caring concepts, and the frequently used concept throughout all 10 studies was enabling. DISCUSSION Recruitment approaches employed to accrue older African-American adults into chronic illness-related research studies necessitate proactive recruitment strategies that incorporate caring behaviors. Future researchers ought to develop multi-modality recruitment strategies to improve older African-American adults' representation.
Collapse
Affiliation(s)
- Charlene J Gamboa
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | | |
Collapse
|
5
|
Hawkins J, Kloss K, Funnell M, Nwankwo R, Schwenzer C, Smith F, Piatt G. Michigan Men's diabetes project (MenD): protocol for a peer leader diabetes self-management education and support intervention. BMC Public Health 2021; 21:562. [PMID: 33752609 PMCID: PMC7983198 DOI: 10.1186/s12889-021-10613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background Black men are more likely to be diagnosed with type 2 diabetes (T2D) compared to non-Hispanic White men, and this disparity increases among men over the age of 55. A growing body of literature demonstrates the critical role of gender in the management of health behaviors such as T2D and shows that male gender norms can conflict with healthy behaviors. These studies suggest that tailoring diabetes self-management interventions to address the needs of Black men may be critical to helping them to achieve optimal health outcomes. Further, our own research on Blacks with T2D found gender disparities in participation in diabetes interventions, with males participating at significantly lower rates than females. Peer leaders are trained lay individuals who are used to provide ongoing diabetes self-management support to people with diabetes, particularly in minority communities. However, despite studies showing that diabetes management interventions using peer leaders have been successful, the majority of peer leaders as well as the participants in those studies are women. The limited studies to date suggest that Black men with T2D prefer peer-led, male-to-male T2D programs, however, this research consists primarily of nonrandomized, small sample feasibility studies calling for additional studies to establish the efficacy of these approaches. The proposed study will develop and preliminarily validate the effectiveness of an adapted peer leader diabetes self-management support (PLDSMS) intervention designed to improve diabetes-related lifestyle and self-management behaviors in Black men (over 55) with T2D. Method We propose to tailor an existing intervention by 1) our using male peers and 2) modifying the peer leader training content to focus on material appropriate for men. The proposed study includes a developmental phase (development of the intervention with expert feedback, followed by feasibility testing with Black men) and a validation phase [randomized clinical trial (RCT)]. Discussion If successful, this study will lead to the development and dissemination of an intervention that will address the unique needs of Black men with T2D, helping them to achieve optimal diabetes self-management and health outcomes. Trial registration Registered at ClinicalTrials.gov with an ID NCT04760444 on February 17, 2021
Collapse
Affiliation(s)
- Jaclynn Hawkins
- University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA.
| | - Katherine Kloss
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| | - Martha Funnell
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| | - Robin Nwankwo
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| | - Claudia Schwenzer
- University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA
| | - Fonda Smith
- University of Michigan, School of Social Work, 1080 S. University, Ann Arbor, MI, 48109, USA
| | - Gretchen Piatt
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine, Ann Arbor, MI, 48109, USA
| |
Collapse
|
6
|
Campbell JA, Egede LE. Individual-, Community-, and Health System-Level Barriers to Optimal Type 2 Diabetes Care for Inner-City African Americans: An Integrative Review and Model Development. DIABETES EDUCATOR 2019; 46:11-27. [PMID: 31802703 DOI: 10.1177/0145721719889338] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE The purpose of this integrative review is (1) to elucidate the unique barriers faced by inner-city African Americans for type 2 diabetes (T2DM) care; (2) to identify effective interventions/programs for optimal T2DM care at the individual, community, and health systems levels; and (3) to integrate 2 behavioral models and 1 social ecological model for framing interventions for inner-city African American to optimize T2DM care. METHODS PRISMA guidelines were followed to systematically search PubMed, PsychInfo, and CINAHL. Integration of models was based on underlying principles of social ecological models. RESULTS The search returned 1183 articles. Forty-six articles were synthesized after applying inclusion criteria. Multiple barriers for the individual level, community level, and health system level were identified. Major barriers include lack of knowledge, lack of social support, and self-management support. Interventions identified in this review show that among inner-city African Americans with T2DM, the focus is placed at the health systems level, with very limited focus toward addressing individual- and community-level barriers. Final synthesis includes development of a new integrated model that explains barriers to care across multiple levels. CONCLUSIONS These findings highlight the fragmentation that may be occurring between policy, research, and practice for achieving health equity and addressing health disparities for T2DM care among inner-city African Americans. The new model is an important step in the pursuit of equity in T2DM by specifying the complex barriers that occur across multiple levels. The application of this model using the 2017 National Standards for Diabetes-Self Management Education and Support are discussed.
Collapse
Affiliation(s)
- Jennifer A Campbell
- Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Center for Advancing Population Science, Milwaukee, Wisconsin.,Joseph Zilber School of Public Health University of Wisconsin Milwaukee Community and Behavioral Health Promotion PhD Program, Milwaukee, Wisconsin
| | - Leonard E Egede
- Medical College of Wisconsin, Department of Medicine, Division of General Internal Medicine, Center for Advancing Population Science, Milwaukee, Wisconsin.,Joseph Zilber School of Public Health University of Wisconsin Milwaukee Community and Behavioral Health Promotion PhD Program, Milwaukee, Wisconsin
| |
Collapse
|
7
|
Abstract
PURPOSE OF REVIEW This article discusses the state of type 2 diabetes (T2D) self-management research on non-Hispanic Black men with a focus on their knowledge of diabetes, factors that impact T2D self-management and intervention research that specifically targets non-Hispanic Black men with T2D. RECENT FINDINGS Studies on T2D knowledge and barriers and facilitators to T2D self-management in non-Hispanic Black men are limited to small qualitative focus group and in-depth interviews. To date, few T2D interventions for non-Hispanic Black men have been developed and tested. Research shows that non-Hispanic Black men's knowledge of T2D may be less than optimal compared to non-Hispanic white men. Factors that influence T2D self-management in non-Hispanic Black men include gender-related values and beliefs, and a range of other psychosocial (e.g., social support) and structural (e.g., access to health care) factors. Interventions with gender-specific programming may show promise. More studies with larger sample sizes and longitudinal designs are needed to develop programming to effectively target this at-risk population.
Collapse
Affiliation(s)
- Jaclynn M Hawkins
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI, 48109, USA.
| |
Collapse
|
8
|
Parker S, Prince A, Thomas L, Song H, Milosevic D, Harris MF. Electronic, mobile and telehealth tools for vulnerable patients with chronic disease: a systematic review and realist synthesis. BMJ Open 2018; 8:e019192. [PMID: 30158214 PMCID: PMC6119429 DOI: 10.1136/bmjopen-2017-019192] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 03/06/2018] [Accepted: 03/13/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The objective of this review was to assess the benefit of using electronic, mobile and telehealth tools for vulnerable patients with chronic disease and explore the mechanisms by which these impact patient self-efficacy and self-management. DESIGN We searched MEDLINE, all evidence-based medicine, CINAHL, Embase and PsychINFO covering the period 2009 to 2018 for electronic, mobile or telehealth interventions. Quality was assessed according to rigour and relevance. Those studies providing a richer description ('thick') were synthesised using a realist matrix. SETTING AND PARTICIPANTS Studies of any design conducted in community-based primary care involving adults with one or more diagnosed chronic health condition and vulnerability due to demographic, geographic, economic and/or cultural characteristics. RESULTS Eighteen trials were identified targeting a range of chronic conditions and vulnerabilities. The data provided limited insight into the mechanisms underpinning these interventions, most of which sought to persuade vulnerable patients into believing they could self-manage their conditions through improved symptom monitoring, education and support and goal setting. Patients were relatively passive in the interaction, and the level of patient response attributed to their intrinsic level of motivation. Health literacy, which may be confounded with motivation, was only measured in one study, and eHealth literacy was not assessed. CONCLUSIONS Research incorporating these tools with vulnerable groups is not comprehensive. Apart from intrinsic motivation, health literacy may also influence the reaction of vulnerable groups to technology. Social persuasion was the main way interventions sought to achieve better self-management. Efforts to engage patients by healthcare providers were lower than expected. Use of social networks or other eHealth mechanisms to link patients and provide opportunities for vicarious experience could be further explored in relation to vulnerable groups. Future research could also assess health and eHealth literacy and differentiate the specific needs for vulnerable groups when implementing health technologies.
Collapse
Affiliation(s)
- Sharon Parker
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy Prince
- South Western Sydney Primary Health Network, Campbelltown, New South Wales, Australia
| | - Louise Thomas
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Hyun Song
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Diana Milosevic
- Planning Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Mark Fort Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
9
|
Hawkins J, Mitchell J, Piatt G, Ellis D. Older African American Men's Perspectives on Factors That Influence Type 2 Diabetes Self-Management and Peer-Led Interventions. Geriatrics (Basel) 2018; 3:geriatrics3030038. [PMID: 31011076 PMCID: PMC6319245 DOI: 10.3390/geriatrics3030038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 11/16/2022] Open
Abstract
Older African American men are at increased risk of Type 2 Diabetes (T2D) but demonstrate high rates of poor illness management. They also participate in interventions targeting illness management at extremely low rates and are at high risk for dropout from clinical trials. One modifiable factor that has been identified in the literature that contributes to these disparities is health beliefs particular to men. Yet, despite the fact that illness management interventions have been developed to meet the needs of African Americans, none have followed recommendations to use gender-sensitive programming to meet the needs of men. The primary aim of this study was to advance our understanding of the intersection of age, race/ethnicity and gender on T2D self-management among older African American men, and to explore their preferences for a peer-led T2D self-management intervention. Two focus groups were conducted with older African American men (n = 12) over a 6-month period. Sessions lasted 90 min, were audiotaped, and analyzed using thematic content analysis techniques. The most prominent themes included: (a) the influence of gendered values and beliefs on health behavior; (b) quantity and quality of patient-provider communication; (c) social and structural barriers to T2D self-management; and (d) preferences for peer-led T2D self-management interventions. Results suggest that these themes may be particularly salient for T2D self-management in older African American men, and that this population may be receptive to a peer-led T2D self-management intervention.
Collapse
Affiliation(s)
- Jaclynn Hawkins
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Jamie Mitchell
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Gretchen Piatt
- School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Deborah Ellis
- School of Medicine, Wayne State University, Detroit, MI 48202, USA.
| |
Collapse
|
10
|
Hood S, Irby-Shasanmi A, de Groot M, Martin E, LaJoie AS. Understanding Diabetes-Related Distress Characteristics and Psychosocial Support Preferences of Urban African American Adults Living With Type 2 Diabetes: A Mixed-Methods Study. DIABETES EDUCATOR 2018; 44:144-157. [PMID: 29375023 DOI: 10.1177/0145721718754325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this study is to understand diabetes-related distress (DRD) characteristics and identify psychosocial support preferences of urban African American adults living with type 2 diabetes (T2DM). Methods A 2-phase, mixed-methods sequential explanatory study design was used to gather data. In phase 1, a purposive sample of participants (N = 155) was recruited and asked to complete a written survey. The Diabetes Distress Scale (DDS17) was used to assess DRD, including subscales-emotional burden (EB), regimen distress (RD), interpersonal distress (ID), and physician distress (PD). In phase 2, a subset of phase 1 participants (N = 23) volunteered to attend 1 of 4 gender-stratified follow-up focus groups to contextualize the quantitative survey results. Results Survey findings indicate that on average, participants had moderate levels of DRD (aggregate), RD, and EB but had low ID and PD. During follow-up focus groups, participants described RD and EB as their primary distress types and emphasized that clinicians should prioritize the mental health aspects of T2DM similarly to its physical aspects. Participants expressed a desire for culturally appropriate peer support groups as a psychosocial support resource for distress coping and specifically requested the development of gender-stratified groups and groups for young adults. Conclusions Results support the need to screen for and address diabetes-related distress among African American patients with T2DM. Findings also inform the development of culturally appropriate psychosocial support resources to facilitate diabetes-related distress coping.
Collapse
Affiliation(s)
- Sula Hood
- Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Amy Irby-Shasanmi
- Department of Sociology, University of West Georgia, Carrolton, Georgia
| | - Mary de Groot
- Division of Endocrinology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Elissabeth Martin
- University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas
| | - Andrew S LaJoie
- Department of Health Promotion and Behavioral Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky
| |
Collapse
|
11
|
Clark B, Boghani S, Grullon C, Batista M. The Impact of a Worksite-Based Diabetes Prevention Intervention: A Pilot Study. Popul Health Manag 2016; 20:233-238. [PMID: 27623353 DOI: 10.1089/pop.2016.0055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to assess the impact of a program to prevent the development of type 2 diabetes among participants with prediabetes. The program focused on a healthy eating style, behavior modification, daily physical activity, and achieving a healthy weight. This was a retrospective observational analysis of a pilot program designed to prevent diabetes among employees with prediabetes. This intervention involved 12-16 weeks of nutrition counseling with the registered dietitian and participation in physical activity of at least 150 min/week. The primary outcome for this study was the prevention of type 2 diabetes. Secondary outcome measures included changes in the following biometrics: body mass index (BMI), systolic blood pressure (SBP), diastolic blood press (DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, waist circumference, and triglyceride levels. The diabetes prevention intervention was associated with significant improvements in glucose (-6.6%), A1c (-2.9%), weight (-5.5%), BMI (-5.5%), SBP (-4.9%), DBP (-3.9%), total cholesterol (-5.0%), LDL-C (-7.0%), and triglycerides (-13.9%). After the 12-16-week intervention, the prevalence of prediabetes was reduced by 31% by fasting blood glucose or A1c levels. Baseline A1c, baseline glucose level, age, and number of sessions attended were all significant predictors of the odds of transitioning out of the prediabetes stage, controlling for all other covariates in the model. This pilot study suggests that the implementation of a worksite diabetes prevention intervention can help employees transition from a prediabetes status to no risk of diabetes.
Collapse
Affiliation(s)
- Bobby Clark
- 1 Department of Health Analytics, Research, and Reporting, Walgreen Co. , Deerfield, Illinois
| | - Safia Boghani
- 1 Department of Health Analytics, Research, and Reporting, Walgreen Co. , Deerfield, Illinois
| | - Cristina Grullon
- 2 Department of Operations, Premise Health , Brentwood, Tennessee
| | - Marcia Batista
- 2 Department of Operations, Premise Health , Brentwood, Tennessee
| |
Collapse
|
12
|
Lee LT, Willig AL, Agne AA, Locher JL, Cherrington AL. Challenges to Healthy Eating Practices: A Qualitative Study of Non-Hispanic Black Men Living With Diabetes. DIABETES EDUCATOR 2016; 42:325-35. [PMID: 27036128 DOI: 10.1177/0145721716640904] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to explore current dietary practices and perceived barriers to healthy eating in non-Hispanic black men with type 2 diabetes. METHODS Four 90-minute focus groups held in September and October 2011 were led by a trained moderator with a written guide to facilitate discussion on dietary practices and barriers to healthy eating. Participants were recruited from the diabetes database at a public safety-net health system in Jefferson County, Alabama. Two-independent reviewers performed content analysis to identify major themes using a combined deductive and inductive approach. RESULTS There were 34 male participants aged 18 years and older. Mean years living with diabetes was 9.6 ± 5.9. Sixty-two percent of participants perceived themselves to be in fair or poor health. Participants' self-reported eating practices did not always relate to hunger. Internal cues to eat included habit and response to emotions, and external cues to eat included media messaging, medication regimens, and work schedules. Men identified multiple barriers to healthy eating including hard-to-break habits, limited resources and availability of food at home and in neighborhood grocery stores, and perceived poor communication with health care professionals. CONCLUSION Non-Hispanic black men acknowledged the importance of healthy eating as part of diabetes self-management but reported various internal and external challenges that present barriers to healthy eating. Tailored strategies to overcome barriers to healthy eating among non-Hispanic black men should be developed and tested for their impact on diabetes self-management.
Collapse
Affiliation(s)
- Loretta T Lee
- School of Nursing, Acute, Chronic, and Continuing Care, University of Alabama at Birmingham (Dr Lee)
| | - Amanda L Willig
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham (Dr Willig)
| | - April A Agne
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (Ms Agne, Dr Cherrington)
| | - Julie L Locher
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham (Dr Locher)
| | - Andrea L Cherrington
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (Ms Agne, Dr Cherrington)
| |
Collapse
|