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The Development, Implementation, and Process Evaluation of the REACH Detroit Partnership's Diabetes Lifestyle Intervention

From the School of Public Health, Department of Health Behavior and Health Education (Dr Two Feathers, Dr Kieffer, Dr Janz); School of Public Health, Departments of Epidemiology and Health Behavior and Health Education (Dr James); and the School of Social Work (Dr Spencer), University of Michigan, Ann Arbor. From Community Health and Social Services, Inc, Detroit, Michigan (Ms Palmisano, Mr Anderson, and Mr Guzman). Dr Two Feathers is now at the Alaska Native Tribal Health Consortium in Anchorage, Alaska. Dr Kieffer is now in the School of Social Work, University of Michigan, Ann Arbor. Dr James is now the Susan B. King professor of public policy studies and professor of sociology and family and community medicine at Duke University, Durham, North Carolina.

Correspondence to Jacqueline Two Feathers, MPH, PhD, 4000 Ambassador Drive, C-DCHS, Anchorage, AK 99508 (jtwofeathers{at}anthc.org).

Purpose

The purpose of this article was to describe the development, implementation, and process evaluation findings of a culturally tailored diabetes lifestyle intervention for African Americans and Latinos.

Methods

African American and Latino adults with type 2 diabetes from 3 health care systems in Detroit, Michigan, participated in diabetes lifestyle intervention of the Racial and Ethnic Approaches to Community Health Detroit Partnership. The intervention curricula were culturally and linguistically tailored for each population. Trained community residents delivered the curricula in 5 group meetings aimed at improving dietary, physical activity, and diabetes self-care behaviors of study participants. The aims of the process evaluation were to assess participant satisfaction with the intervention, utility, and applicability of information and cultural relevance of intervention materials. Content analysis was used to analyze qualitative data. Matrices were developed along thematic lines, and common themes were determined by grouping responses by question.

Results

Ninety-eight percent of participants attended 1 or more intervention classes; 41% attended all 5 meetings. Attendance rates ranged from 59% to 88% for individualmeetings. Participants reported that program information and activities were useful, culturally relevant, and applicable to diabetes self-management. Participants also appreciated the convenient community location for meetings and the social support received from other participants.

Conclusions

A community-based, culturally tailored diabetes lifestyle intervention delivered by trained community residents was associated with high participant satisfaction and retention.

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