Dietary Education for Rural, Black Persons with Diabetes

University Of South Carolina At Columbia, Columbia SC

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Abstract

Rural minority populations in the South bear a disproportionate burden of type 2 diabetes, its complications, and its costs. Diabetes education can reduce avoidable risk factors for complications; yet, traditional diabetes education approaches have been ineffective for these populations. The goal of this research is to facilitate culturally- competent, dietary self-management in high-risk African-Americans with Type 2 diabetes living in rural South Carolina. The specific aim is to test the effects of a dietary self-management education intervention on (a) physiological outcomes (glycosylated hemoglobin, lipids, and weight); (b) dietary habits; and (c) costs of care (hospital length of stay and acute care visits). A longitudinal experimental study is proposed, using a pretest-post-test control group design with random assignment to the experimental group (n=63) or to the control group (n=62). The sample will be recruited from a Southern, rural community. The experimental group will receive the intervention. The control group will receive the usual care, referral to a dietician. The intervention consists of four classes in low-fat dietary strategies, peer-professional group discussions, and follow-up by a nurse case manager who is a certified diabetes educator. The uniqueness of this intervention is that it not only reflects awareness of cultural values of African-Americans, but it also seeks to integrate these values into healthy dietary strategies by incorporating Southern African-American learning methods, foods, and social approaches. Both groups will be tested at baseline and 6 months post intervention. Self-reported data will be collected with the Food Habits and the Costs of Care questionnaires. Repeated measures MANOVA and repeated measures ANOVA will be used to analyze the data.