Picture Good Health: A Church-Based Self-Management Intervention Among Latino Adults with Diabetes

ABSTRACT 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 Lat...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2015-10, Vol.30 (10), p.1481-1490
Main Authors: Baig, Arshiya A., Benitez, Amanda, Locklin, Cara A., Gao, Yue, Lee, Sang Mee, Quinn, Michael T., Solomon, Marla C., Sánchez-Johnsen, Lisa, Burnet, Deborah L., Chin, Marshall H.
Format: Article
Language:English
Subjects:
Adult
Adults
Aged
Blood pressure
Blood Pressure - physiology
Catholicism
Churches
Confidence intervals
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - ethnology
Diabetes Mellitus, Type 2 - therapy
Disease control
Disease management
Early Medical Intervention - methods
Exercise - physiology
Female
Follow-Up Studies
Food
Food consumption
Health Behavior - ethnology
Health care
Hemoglobin
Hispanic Americans - ethnology
Humans
Income
Internal Medicine
Intervention
Lipoproteins
Low density lipoprotein
Low income groups
Male
Medicine
Medicine & Public Health
Middle Aged
Original Research
Pilot Projects
Self Care - methods
Social interactions
Statistical analysis
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Summary:ABSTRACT 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. DESIGN This was a community-based, randomized controlled, pilot study. SUBJECTS One-hundred adults with self-reported diabetes from a Midwestern, urban, low-income Mexican-American neighborhood were included in the study. INTERVENTIONS 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. OUTCOME MEASURES 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. KEY 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.
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-015-3339-x