A self-management intervention for African Americans with comorbid diabetes and hypertension: a pilot randomized controlled trial

Prev Chronic Dis. 2014 May 29;11:E90. doi: 10.5888/pcd11.130349.

Abstract

Introduction: The objective of this pilot 6-month randomized controlled trial was to determine the effectiveness of an intensive, community-based, group intervention that focused on diet, physical activity, and peer support for reducing weight among urban-dwelling African Americans with comorbid type 2 diabetes and hypertension.

Methods: Sixty-one participants were randomized into an intervention or control group. The 6-month intervention consisted of 18 group sessions led by a dietitian in a community setting and weekly telephone calls from a peer supporter. The intervention featured culturally tailored nutrition education, behavioral skills training, and social support focused on changes to diet and physical activity. The control group consisted of two 3-hour group sessions of diabetes self-management education taught by a community health worker. Outcome measures were assessed at baseline and 6 months. The primary outcome was achievement of a 5% weight reduction at 6 months. A secondary outcome was achievement of a 0.5 percentage-point reduction in hemoglobin A1c (HbA1c).

Results: Groups did not differ in achievement of the weight-loss goal. Intervention participants lost a mean of 2.8 kg (P = .01); control participants did not lose a significant amount of weight. A greater proportion of intervention (50.0%) than control (21.4%) participants reduced HbA1c by 0.5 percentage points or more at 6 months (P = .03).

Conclusion: The intervention was more effective than usual care (short-term diabetes education) at improving glycemic control, but not weight, in low-income African Americans with comorbid diabetes and hypertension. A community-based 6-month group class with culturally tailored education, behavioral skills training, and peer support can lead to a clinically significant reduction in HbA1c.

Trial registration: ClinicalTrials.gov NCT01244152.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Americans / psychology*
  • African Americans / statistics & numerical data
  • Body Mass Index
  • Chicago / epidemiology
  • Comorbidity
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / therapy*
  • Exercise / psychology*
  • Female
  • Food Preferences / ethnology
  • Food Preferences / psychology
  • Glycated Hemoglobin A / metabolism
  • Health Behavior
  • Humans
  • Hypertension / epidemiology
  • Hypertension / ethnology
  • Hypertension / therapy*
  • Life Style
  • Male
  • Middle Aged
  • Nutritional Sciences / education
  • Outcome Assessment, Health Care* / statistics & numerical data
  • Patient Education as Topic
  • Pilot Projects
  • Self Care / methods*
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A

Associated data

  • ClinicalTrials.gov/NCT01244152