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

• Published in: Journal of general internal medicine : JGIM Vol. 30; no. 10; pp. 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: Journal Article
• Language: English
• Published: New York Springer US 01-10-2015; Springer Nature B.V
• 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; diabetes; Latino; CBPR; church-based intervention
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-015-3339-x

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.