domingo, 8 de junio de 2014

Preventing Chronic Disease | A Self-Management Intervention for African Americans With Comorbid Diabetes and Hypertension: A Pilot Randomized Controlled Trial - CDC

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Preventing Chronic Disease | A Self-Management Intervention for African Americans With Comorbid Diabetes and Hypertension: A Pilot Randomized Controlled Trial - CDC



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A Self-Management Intervention for African Americans With Comorbid Diabetes and Hypertension: A Pilot Randomized Controlled Trial

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Elizabeth B. Lynch, PhD; Rebecca Liebman, MPH; Jennifer Ventrelle, MS, RD; Elizabeth F. Avery, MS; DeJuran Richardson, PhD

Suggested citation for this article: Lynch EB, Liebman R, Ventrelle J, Avery EF, Richardson D. A Self-Management Intervention for African Americans With Comorbid Diabetes and Hypertension: A Pilot Randomized Controlled Trial. Prev Chronic Dis 2014;11:130349. DOI: http://dx.doi.org/10.5888/pcd11.130349External Web Site Icon.
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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.


Author Information

Corresponding Author: Elizabeth B. Lynch, PhD, Department of Preventive Medicine, Rush University Medical Center, 1700 West Van Buren, Suite 470, Chicago, IL 60657. Telephone: 312-563-2254. E-mail: elizabeth_lynch@rush.edu.
Author Affiliations: Rebecca Liebman, Jennifer Ventrelle, Elizabeth F. Avery, Rush University Medical Center, Chicago, Illinois; DeJuran Richardson, Rush University Medical Center, Chicago, Illinois, and Lake Forest College, Lake Forest, Illinois. Dr Lynch is also affiliated with Lake Forest College, Lake Forest, Illinois.
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