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A Resilience Intervention in African American Adults With Type 2 Diabetes

A Pilot Study of Efficacy

From the Department of Kinesiology and Health Education (Dr Steinhardt); Department of Human Ecology, College of Natural Sciences (Dr Mamerow); School of Nursing (Dr Brown); and Department of Human Ecology, College of Natural Sciences (Dr Jolly), University of Texas at Austin.

Correspondence to Mary A. Steinhardt, EdD, LPC, Department of Kinesiology and Health Education, Bellmont Hall 222, University of Texas at Austin, Austin, TX 78712 (msteinhardt{at}mail.utexas.edu)

Purpose

The purpose of this pilot study was to determine the feasibility of offering the authors' Diabetes Coaching Program (DCP), adapted for African Americans, in a sample of African American adults with type 2 diabetes.

Methods

The study used a 1-group, pretest-posttest design to test the acceptance and potential effectiveness of the DCP. Subjects were a convenience sample of 16 African Americans (8 women, 8 men) with type 2 diabetes; 12 subjects (6 women, 6 men) completed the program. The DCP included 4 weekly class sessions devoted to resilience education and diabetes self-management, followed by 8 biweekly support group meetings. Psychosocial process variables (resilience, coping strategies, diabetes empowerment) and proximal (perceived stress, depressive symptoms, diabetes self-management) and distal outcomes (body mass index [BMI], fasting blood glucose, HbA1C, lipidemia, blood pressure) were assessed at baseline and at 6 months after study entry. Qualitative data were collected at 8 months via a focus group conducted to examine the acceptability of the DCP.

Results

Preliminary paired t tests indicated statistically significant improvements in diabetes empowerment, diabetes self-management, BMI, HbA1c, total cholesterol, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure. Medium to large effect sizes were reported. Resilience, perceived stress, fasting blood glucose, and high-density lipoprotein cholesterol improved, but changes were not statistically significant. Focus group data confirmed that participants held positive opinions regarding the DCP and follow-up support group sessions, although they suggested an increase in program length from 4 to 8 weeks.

Conclusions

The pilot study documented the feasibility and potential effectiveness of the DCP to enhance diabetes empowerment, diabetes self-management, and reductions in the progression of obesity, type 2 diabetes, and cardiovascular disease in the African American community. Randomized experimental designs are needed to confirm these findings.

This version was published on March 1, 2009

The Diabetes Educator, Vol. 35, No. 2, 274-284 (2009)
DOI: 10.1177/0145721708329698


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